McDaniel J S, Purcell D W, Farber E W
Grady Health System Infectious Disease Program, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Clin Psychol Rev. 1997;17(3):311-25. doi: 10.1016/s0272-7358(97)00021-4.
Medical and neuropsychiatric sequelae of HIV infection present a spectrum of diagnostic and treatment challenges to mental health clinicians. Both HIV and the many opportunistic infections that manifest in patients due to their immunocompromised state also can affect the central nervous system (CNS). Thus, mental health clinicians need to be familiar with the diagnosis and management of HIV-related medical and psychiatric complications. This article provides an overview of the CNS-related manifestations resulting from HIV disease, including HIV-related dementia, psychotic disorders, delirium, CNS opportunistic infections and tumors, systemic abnormalities, psychoactive substances, and the adverse effects of certain medical treatments. Treatment strategies for individuals with HIV disease and comorbid severe mental illness are outlined and recommendations for future research are offered.
HIV感染的医学和神经精神后遗症给心理健康临床医生带来了一系列诊断和治疗挑战。HIV以及患者因免疫功能低下状态而出现的许多机会性感染，都可能影响中枢神经系统（CNS）。因此，心理健康临床医生需要熟悉HIV相关医学和精神并发症的诊断与管理。本文概述了HIV疾病导致的与CNS相关的表现，包括HIV相关痴呆、精神障碍、谵妄、CNS机会性感染和肿瘤、全身异常、精神活性物质以及某些医学治疗的不良反应。概述了HIV疾病合并严重精神疾病患者的治疗策略，并提出了未来研究的建议。
