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在高活性抗逆转录病毒疗法下脑脊髓液病毒逃逸:来自单一三级护理中心的分析

Ravinder Kaur Sachdeva¹, G S R S N K Naidu¹, Pooja Chauhan¹

¹Antiretroviral Treatment Centre (ARTC), Department of Internal Medicine, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.

AIDS research and human retroviruses

|February 17, 2024

概括

接受抗逆转录病毒疗法 (ART) 的个人可以在脑脊液 (CSF) 中经历HIV病毒逃逸,尽管血液病毒载量被抑制. 早期检测和ART治疗方案的改变可以逆转神经功能障碍,改善患者的治疗结果.

科学领域:

神经科学是一个神经科学.
传染性疾病传染性疾病
病毒学病毒学

背景情况:

抗逆转录病毒疗法 (ART) 是HIV管理的标准.
接受ART治疗的HIV感染者仍然可以在脑脊液 (CSF) 中产生高的病毒载荷,即使血病毒载荷被抑制.
这种现象被称为CSFHIV病毒逃逸,可以导致神经系统并发症.

研究的目的:

为了调查艾滋病毒感染患者的神经症状和诊断的CSF艾滋病毒病毒逃逸的病例.
在诊断时分析血和脑脊髓液中的临床表现,共感染和病毒载荷.
为了评估在CSF病毒逃逸识别后ART治疗方案修改的结果.

主要方法:

对2014年6月至2021年12月期间被诊断患有CSFHIV病毒逃逸的HIV感染患者的医疗记录的回顾性审查.
收集的数据包括临床征兆,症状,机会性感染,以及血和脑脊髓液中的HIV病毒副本.
在ART疗法转换后,对病毒载荷和患者结局的分析.

主要成果:

十九名患者 (14名病毒学证实,5名临床) 被诊断为CSFHIV病毒逃逸.
中位数CSFHIV病毒载量 (12,773.7副本/毫升) 显著高于血病毒载量 (2,469.8副本/毫升).
在ART转换后,17名患者表现出临床改善和神经功能障碍的逆转;发生1例死亡和1例随访损失.

结论:

在接受ART治疗的HIV感染个体中,CSFHIV病毒逃逸是一个重要的关注点,呈现神经问题.
与血相比,CSF中的较高病毒载荷表明局部病毒复制.
及时诊断和干预,包括ART疗法调整,对于管理神经功能障碍和改善CSFHIV病毒逃逸的治疗结果至关重要.

关键词:

在CSF的CSF中,艾滋病病毒艾滋病病毒艾滋病病毒病毒逃生是病毒逃生.

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