HIV associated neurocognitive disorders (HAND) are the spectrum of cognitive impairments present in patients infected with human immunodeficiency virus type 1 (HIV-1). The number of patients affected with HAND ranges from 30 to 50% of HIV infected individuals and although the development of combinational antiretroviral therapy (cART) has improved longevity, HAND continues to pose a significant clinical problem as the current standard of care does not alleviate or prevent HAND symptoms. At present, the pathological mechanisms contributing to HAND remain unclear, but evidence suggests that it stems from neuronal injury due to chronic release of neurotoxins, chemokines, viral proteins, and proinflammatory cytokines secreted by HIV-1 activated microglia, macrophages and astrocytes in the central nervous system (CNS). Furthermore, the blood–brain barrier (BBB) not only serves as a route for HIV-1 entry into the brain but also prevents cART therapy from reaching HIV-1 brain reservoirs, and therefore could play an important role in HAND. The goal of this review is to discuss the current data on the epidemiology, pathology and research models of HAND as well as address the potential pharmacological treatment approaches that are being investigated.

中文翻译：

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治疗 HIV-1 相关神经认知障碍的潜在药理学方法


HIV 相关神经认知障碍 (HAND) 是感染 1 型人类免疫缺陷病毒 (HIV-1) 的患者出现的一系列认知障碍。受 HAND 影响的患者数量占 HIV 感染者的 30% 至 50%，尽管联合抗逆转录病毒疗法 (cART) 的发展提高了寿命，但 HAND 仍然构成重大的临床问题，因为当前的护理标准并不能缓解或缓解这一问题。预防手部症状。目前，导致HAND的病理机制尚不清楚，但有证据表明，其源于中枢神经系统中HIV-1激活的小胶质细胞、巨噬细胞和星形胶质细胞分泌的神经毒素、趋化因子、病毒蛋白和促炎细胞因子导致的神经元损伤。神经系统（CNS）。此外，血脑屏障（BBB）不仅是HIV-1进入大脑的途径，而且还能阻止cART疗法到达HIV-1脑库，因此可能在HAND中发挥重要作用。本综述的目的是讨论 HAND 流行病学、病理学和研究模型的当前数据，并讨论正在研究的潜在药物治疗方法。