| Title |
Su ŽIV susijusių neurokognityvinių sutrikimų patofiziologija ir gydymas – literatūros apžvalga / |
| Translation of Title |
Pathophysiology and treatment of HIV-related neurocognitive disorders – literature review. |
| Authors |
Vysocki, Dioniz ; Pilipavičius, Lukas |
| DOI |
10.53453/ms.2024.11.4 |
| Full Text |
|
| Is Part of |
Medicinos mokslai = Journal of medical sciences.. Kaunas : VšĮ Lietuvos sveikatos mokslinių tyrimų centras. 2024, vol. 12, iss. 5, p. 39-46.. ISSN 2345-0592 |
| Keywords [eng] |
HIV ; neurocognitive ; disorders ; antiretroviral treatment |
| Abstract [eng] |
Background. Human immunodeficiency virus (HIV), once considered fatal, can now be managed with combined antiretroviral treatment (CART). However, despite expectations of decreasing case numbers, Lithuania's 2022 HIV-1 statistics show an opposite trend. HIV infiltrates and reproduces in brain microglia within the first week of infection, contributing to neurocognitive impairment in up to half of all patients. CART is not always successful in brain virus eradication. A better understanding of pathophysiology of HIV in the brain is expected to lead to the discovery of successful treatments for HIV neurocognitive disorders. Aim: to review the literature on HIV-induced neurocognitive disorders and present their pathophysiology and treatment options. Methods. A literature review was conducted on the PubMed database, using keywords: "HIV“, "neurocognitive disorder“, "dementia“, "antiretroviral therapy“, and "blood brain barrier“. Articles published in the last 14 years in English were selected for the analysis. Results. Brain microglia is a particularly favourable breeding ground for HIV. Cognitive impairment is related to timing of antiretroviral therapy. Not all antiretroviral therapies penetrate the blood-brain barrier, so microglia cells may remain an HIV reservoir even if no viremia is detected in blood. Pathological changes are observed in laboratory and imaging studies even though viremia is suppressed in blood. Cognitive impairment less often manifests as dementia and more often as milder disorders. Conclusions. The main treatment for HIV-induced neurocognitive disorders remains the control of viremia with CART. However, in some patients, latent HIV persists in the brain even after achieving systemic virological control. |
| Published |
Kaunas : VšĮ Lietuvos sveikatos mokslinių tyrimų centras |
| Type |
Journal article |
| Language |
Lithuanian |
| Publication date |
2024 |
| CC license |
|
