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Neuropathogenesis of human immunodeficiency virus infection.
Sillman, Brady; Woldstad, Christopher; Mcmillan, Joellyn; Gendelman, Howard E.
Afiliación
  • Sillman B; Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States.
  • Woldstad C; Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States.
  • Mcmillan J; Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States.
  • Gendelman HE; Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States. Electronic address: hegendel@unmc.edu.
Handb Clin Neurol ; 152: 21-40, 2018.
Article en En | MEDLINE | ID: mdl-29604978
ABSTRACT
Human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) remain a common end-organ manifestation of viral infection. Subclinical and mild symptoms lead to neurocognitive and behavioral abnormalities. These are associated, in part, with viral penetrance and persistence in the central nervous system. Infections of peripheral blood monocytes, macrophages, and microglia are the primary drivers of neuroinflammation and neuronal impairments. While current antiretroviral therapy (ART) has reduced the incidence of HIV-associated dementia, milder forms of HAND continue. Depression, comorbid conditions such as infectious liver disease, drugs of abuse, antiretroviral drugs themselves, age-related neurodegenerative diseases, gastrointestinal maladies, and concurrent social and economic issues can make accurate diagnosis of HAND challenging. Increased life expectancy as a result of ART clearly creates this variety of comorbid conditions that often blur the link between the virus and disease. With the discovery of novel biomarkers, neuropsychologic testing, and imaging techniques to better diagnose HAND, the emergence of brain-penetrant ART, adjunctive therapies, longer life expectancy, and better understanding of disease pathogenesis, disease elimination is perhaps a realistic possibility. This review focuses on HIV-associated disease pathobiology with an eye towards changing trends in the face of widespread availability of ART.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Encéfalo / Barrera Hematoencefálica / Infecciones por VIH / Complejo SIDA Demencia / VIH-1 Límite: Animals / Humans Idioma: En Revista: Handb Clin Neurol Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Encéfalo / Barrera Hematoencefálica / Infecciones por VIH / Complejo SIDA Demencia / VIH-1 Límite: Animals / Humans Idioma: En Revista: Handb Clin Neurol Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos