基础科学和病原发生学
1University of Cape Town, Cape Town, South Africa.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 23, 2025
概括
从以埃法维伦兹为基础的转换为以杜洛特格拉维尔为基础的抗逆转录病毒疗法 (ART) 改善了艾滋病毒感染者的认知功能. 这表明efavirenz可能会引起神经毒性,并且基于dolutegravir的ART支持大脑健康.
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
- 药理学 药理学是指药理学的学科.
背景情况:
- 艾滋病毒感染与认知障碍有关,可能是由于艾滋病毒RNA脑脊液 (CSF) 逃逸.
- 世界卫生组织建议全球从基于埃法维伦兹的抗逆转录病毒疗法 (ART) 转换为基于多卢特格拉维尔的抗逆转录病毒疗法.
- 这种ART切换的认知效应,特别是多卢特格拉维尔的益处,尚不清楚.
研究的目的:
- 调查艾滋病毒成年人从以法维伦兹为基础的转换到以多卢特格拉维尔为基础的ART的认知影响.
- 在ART切换后,将艾滋病毒感染者的认知表现与没有艾滋病毒的人进行比较.
- 评估在ART治疗期间CSFHIVRNA逃逸的发生率.
主要方法:
- 178名艾滋病毒感染成人接受基于efavirenz的ART治疗,95名艾滋病毒阴性对照在基线和1年随访期间接受认知测试.
- 参与者转换为基于多卢特格拉维尔的ART; 艾滋病毒阴性对照维持了他们的状态.
- 脑脊液 (CSF) 样本从艾滋病毒感染者身上收集,以量化艾滋病毒RNA.
主要成果:
- 与对照组相比,艾滋病毒感染者在基线显示全球认知表现明显较低,但在随访时这种差异消失了.
- 艾滋病毒感染者在转换为基于多卢特格拉维尔的ART后,认知能力低下的比例显著下降.
- 艾滋病毒组的认知改善明显大于对照组,这表明治疗效果.
结论:
- 在转换为基于多卢特格拉维尔的ART后,认知能力的改善可能源于减少了efavirenz的神经毒性.
- 基于多卢特格拉维尔的ART与艾滋病毒感染者的认知功能改善和认知障碍率降低有关.
- 脑流体HIVRNA脱离是罕见的,往往是短暂的,这表明在现代ART疗法中,病毒控制和大脑健康良好.
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