感染艾滋病毒的病毒抑制患者的周围神经病变:来自PIVOT试验的证据
Anna L Schuldt1, Henry Bern2, Melanie Hart3
1Institute for Global Health, University College London, London WC1E 6JB, UK.
Viruses
|January 26, 2024
概括
艾滋病毒成年人的外围神经病变 (PN) 与年龄,过去的d-药物暴露,身高,较低的CD4计数和代谢综合征有关. 神经纤维光链 (NfL) 作为PN查的生物标志物没有被证明是有用的.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 生物标志物 生物标志物
背景情况:
- 周围神经病变 (PN) 是艾滋病毒感染的成年人常见的并发症.
- 识别PN的风险因素和可靠的生物标志物对于有效管理这一群体至关重要.
- 以前的研究表明,各种因素有助于PN,但神经丝光链 (NfL) 等特定生物标志物的作用需要进一步调查.
研究的目的:
- 确定与艾滋病病毒病毒学抑制成年人的外围神经病变 (PN) 相关的因素.
- 评估神经纤维光链 (NfL) 作为检测PN在这个队列中的潜在生物标志物.
- 探索抗逆转录病毒疗法的长期影响,包括蛋白酶抑制剂单疗与三重疗法对PN发展的影响.
主要方法:
- 该研究分析了PIVOT试验的数据,包括具有基线PN数据的参与者.
- 使用多变量逻辑回归来评估PN与风险因素之间的关联,例如年龄,性别,CD4细胞计数,抗逆转录病毒药物暴露 (d-药物),血糖和NFL水平.
- 血NfL水平 (pNfL) 在参与者的子集中被测量.
主要成果:
- 在44个月的中位随访期间,22.4%的参与者报告了外围神经病变 (PN).
- PN独立地与年龄较大,有过二氧化核酸 (d-药物) 暴露史,身高,CD4细胞数量最低点和代谢综合征有关.
- 血NfL水平 (pNfL) 在这种人群中没有显示作为PN查测试的额外价值,即使长期病毒抑制.
结论:
- 年龄,累积的d-药物暴露,身高,CD4数和代谢综合征是艾滋病病毒病毒抑制成年人周围神经病变 (PN) 的重要独立风险因素.
- 与过去的d-药物使用的PN持续的关联表明潜在的不可逆转的毒性.
- 神经纤维光链 (NfL) 并不是一个有价值的生物标志物,用于查艾滋病毒感染的有效病毒抑制成年人的外围神经病变.
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