青少年和青年人群中 HIV 对中枢神经系统影响的最新进展。
Update on Central Nervous System Effects of HIV in Adolescents and Young Adults.
机构信息
Division of Neurology, Children's Hospital of Philadelphia, 3501 Civic Center Blvd, Philadelphia, PA, 19104, USA.
Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
出版信息
Curr HIV/AIDS Rep. 2023 Apr;20(2):19-28. doi: 10.1007/s11904-023-00651-3. Epub 2023 Feb 21.
PURPOSE OF REVIEW
: Behaviorally acquired (non-perinatal) HIV infection during adolescence and young adulthood occurs in the midst of key brain developmental processes such as frontal lobe neuronal pruning and myelination of white matter, but we know little about the effects of new infection and therapy on the developing brain.
RECENT FINDINGS
Adolescents and young adults account for a disproportionately high fraction of new HIV infections each year. Limited data exist regarding neurocognitive performance in this age group, but suggest impairment is at least as prevalent as in older adults, despite lower viremia, higher CD4 + T cell counts, and shorter durations of infection in adolescents/young adults. Neuroimaging and neuropathologic studies specific to this population are underway. The full impact of HIV on brain growth and development in youth with behaviorally acquired HIV has yet to be determined; it must be investigated further to develop future targeted treatment and mitigation strategies.
综述目的：在青少年和青年时期发生的行为获得性（非围产期）HIV 感染，发生于大脑关键发育过程之中，例如额叶神经元修剪和白质髓鞘形成，但我们对新感染和治疗对发育中大脑的影响知之甚少。
最新发现：青少年和青年每年占新 HIV 感染的不成比例的高比例。关于该年龄组的神经认知表现，数据有限，但与老年人一样，至少存在认知障碍，尽管青少年/青年的病毒载量较低、CD4+T 细胞计数较高，以及感染持续时间较短。正在针对该人群进行特定的神经影像学和神经病理学研究。HIV 对通过行为获得 HIV 的青少年的大脑生长和发育的全面影响尚未确定；为了制定未来的靶向治疗和缓解策略，还需要进一步进行研究。
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