临床表现 临床表现
Jeremy A Tanner1, Roslyn Valdespino1, Tiffany F Kautz1
1University of Texas Health San Antonio, San Antonio, TX, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 24, 2025
概括
在乌干达,接受抗逆转录病毒疗法 (ART) 的艾滋病毒感染者 (PLWH) 的老年人表现出与没有艾滋病毒的人相似的认知功能和阿尔茨海默病生物标志物水平. 进一步的研究将监测这一群体的认知趋势和阿尔茨海默病和相关痴呆症 (ADRD).
科学领域:
- 神经科学是一个神经科学.
- 老年学是一门学科.
- 传染性疾病 传染性疾病
背景情况:
- 撒哈拉以南非洲地区面临着日益老龄化的人口和越来越多的艾滋病毒感染者 (PLWH) 接受抗逆转录病毒疗法 (ART).
- 在撒哈拉以南非洲的衰老,阿尔茨海默氏症 (AD) 和艾滋病毒的交叉点上存在有限的数据,与全球北方不同,艾滋病毒与神经炎症和认知衰退有关.
- 这项研究解决了乌干达老年PLWH认知衰老和AD生物标志物的数据缺口.
研究的目的:
- 在乌干达接受抗逆转录病毒治疗 (ART) 治疗的艾滋病毒感染者 (PLWH) 老年人中调查认知表现和血阿尔茨海默病和相关痴呆症 (ADRD) 生物标志物.
- 为了比较PLWH和人口统计学上匹配的HIV阴性个体之间的认知功能和ADRD生物标志物.
- 建立基线数据,为未来的纵向研究认知衰老和ADRD在这个人群.
主要方法:
- 乌干达老龄化队列研究 (UACS) 预计将PLWH纳入ART和年龄/性别匹配的对照组.
- 认知功能使用乌干达神经心理电池和基于平板电脑的认知评估工具 (TabCAT) 进行评估,Z分数计算为全球认知和特定领域.
- 测量了包括p-tau217,Aβ42/40,GFAP和NfL在内的血生物标志物,并使用Jak/Bondi标准定义了认知障碍.
主要成果:
- 576名参与者 (平均年龄60岁) 完成了这项研究;在大多数措施中,PLWH和对照组之间的认知表现相似,PLWH的动物流利性得分更高.
- 在PLWH中观察到更高的认知障碍频率和升高的p-tau217的趋势,但差异在统计学上并不显著.
- 在HIV血清状态组之间没有发现血ADRD生物标志物 (p-tau217/Aβ42,Aβ42/40,GFAP,NfL) 的显著差异.
结论:
- 在乌干达,接受ART的老年PLWH表现出与他们的HIV阴性同龄人相比的认知表现和血ADRD生物标志物水平.
- 这些发现与研究结果一致,研究表明病毒抑制的PLWH中认知障碍率较低.
- 需要进一步的纵向研究来跟踪这种老龄化队列中的认知变化和ADRD患病率,特别是关于p-tau217趋势.
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