Chronic Inflammation and the Role for Cofactors (Hepatitis C, Drug Abuse, Antiretroviral Drug Toxicity, Aging) in HAND Persistence

被引：0
作者：
Alexander J. Gill
Dennis L. Kolson
机构：
[1] University of Pennsylvania,Department of Neurology, Perelman School of Medicine
来源：
Current HIV/AIDS Reports | 2014年 / 11卷
关键词：
Inflammation; Human immunodeficiency virus; HIV; HIV associated neurocognitive disorders; HAND; Immune activation; Neurotoxicity; Hepatitis C; HCV; Aging; Drug abuse; Neuropathogenesis; MRI; Magnetic resonance imaging; fMRI; Functional magnetic resonance imaging; Neurocognitive testing; Microbial translocation; Antiretroviral therapy; ART;
D O I：
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中图分类号：
学科分类号：
摘要：
HIV-associated neurocognitive disorders (HAND) is a group of syndromes of varying degrees of cognitive impairment affecting up to 50 % of HIV-infected individuals. The neuropathogenesis of HAND is thought to be driven by HIV invasion and productive replication within brain perivascular macrophages and endogenous microglia, and to some degree by restricted infection of astrocytes. The persistence of HAND in individuals experiencing suppression of systemic HIV viral load with antiretroviral therapy (ART) is incompletely explained, and suggested factors include chronic inflammation, persistent HIV replication in brain macrophages, effects of aging on brain vulnerability, and co-morbid conditions including hepatitis C (HCV) co-infection, substance abuse, and CNS toxicity of ART, among other factors. This review discusses several of these conditions: chronic inflammation, co-infection with HCV, drugs of abuse, aging, and antiretroviral drug effects. Effectively managing these co-morbid conditions in individuals with and without HAND is critical for improving neurocognitive outcomes and decreasing HIV-associated morbidity.
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页码：325 / 335
页数：10
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