Diaz Monica M
Department of Neurology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.
Curr Opin HIV AIDS. 2025 Jul 1;20(4):337-343. doi: 10.1097/COH.0000000000000951. Epub 2025 May 16.
The prevalence of neurological complications among people with HIV (PWH) is expected to increase as PWH live longer due to increased access to antiretroviral treatment (ART). This review provides updates to the understanding of the neurological sequelae, including neurocognitive impairment, neuropathy, neurological opportunistic infections, and others, which are crucial for improving care and outcomes of PWH.
Recent literature highlights several key themes: the pathophysiology of HIV-related neuronal damage involving HIV proteins (gp120, Nef) and neuroinflammation; the role of aging in exacerbating neurological complications; the high prevalence of HIV-associated neurocognitive disorders (HAND) and Alzheimer's disease-related dementias (AD/ADRD) among PWH; the importance of neurocognitive screening tools like IHDS and MoCA; and the identification of biomarkers and neuroimaging techniques for early detection and monitoring of HAND.
The findings highlight the need for comprehensive healthcare strategies to manage neurological complications in PWH, including targeted interventions for high-risk groups, improved diagnostic tools, and tailored treatments. It is important for clinicians and researchers to develop effective approaches to mitigate the impact of HIV on brain health and improve quality of life for PWH.
随着获得抗逆转录病毒治疗(ART)的机会增加,艾滋病毒感染者(PWH)的寿命延长,预计其神经并发症的患病率将会上升。本综述提供了对神经后遗症的最新认识,包括神经认知障碍、神经病变、神经机会性感染等,这些对于改善PWH的护理和预后至关重要。
近期文献突出了几个关键主题:涉及HIV蛋白(gp120、Nef)和神经炎症的HIV相关神经元损伤的病理生理学;衰老在加重神经并发症中的作用;PWH中HIV相关神经认知障碍(HAND)和阿尔茨海默病相关痴呆(AD/ADRD)的高患病率;像国际HIV痴呆量表(IHDS)和蒙特利尔认知评估量表(MoCA)等神经认知筛查工具的重要性;以及用于早期检测和监测HAND的生物标志物和神经影像学技术的识别。
这些发现凸显了需要全面的医疗保健策略来管理PWH的神经并发症,包括针对高危人群的有针对性干预、改进诊断工具和量身定制的治疗。临床医生和研究人员开发有效方法以减轻HIV对大脑健康的影响并改善PWH的生活质量非常重要。