Human immunodeficiency virus animal models and related neuropathy study / 中国药理学通报

Human immunodeficiency virus(HIV) infection may result in serious impairment of the immune system in HIV-posi-tive patients. Both HIV productions and highly active antiretrovi-ral therapy (HAART) drugs can cause neuropathy, including the HIV associated neurocognitive disorders (HAND) and the peripheral neuropathy. Several animal models have been devel-oped in an attempt to study the mechanisms of HIV relative neu-ropathies. This review focuses on researching HIV-1 associated neuropathies by application of HIV-1 animal models.

Altered White Matter Integrity in Human Immunodeficiency Virus-Associated Neurocognitive Disorder: A Tract-Based Spatial Statistics Study

OBJECTIVE: Human immunodeficiency virus (HIV) infection has been known to damage the microstructural integrity of white matter (WM). However, only a few studies have assessed the brain regions in HIV-associated neurocognitive disorders (HAND) with diffusion tensor imaging (DTI). Therefore, we sought to compare the DTI data between HIV patients with and without HAND using tract-based spatial statistics (TBSS). MATERIALS AND METHODS: Twenty-two HIV-infected patients (10 with HAND and 12 without HAND) and 11 healthy controls (HC) were enrolled in this study. A whole-brain analysis of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity was performed with TBSS and a subsequent 20 tract-specific region-of-interest (ROI)-based analysis to localize and compare altered WM integrity in all group contrasts. RESULTS: Compared with HC, patients with HAND showed decreased FA in the right frontoparietal WM including the upper corticospinal tract (CST) and increased MD and RD in the bilateral frontoparietal WM, corpus callosum, bilateral CSTs and bilateral cerebellar peduncles. The DTI values did not significantly differ between HIV patients with and without HAND or between HIV patients without HAND and HC. In the ROI-based analysis, decreased FA was observed in the right superior longitudinal fasciculus and was significantly correlated with decreased information processing speed, memory, executive function, and fine motor function in HIV patients. CONCLUSION: These results suggest that altered integrity of the frontoparietal WM contributes to cognitive dysfunction in HIV patients.

A preliminary study of neurocognitive function of HIV ±/AIDS patients / 中华行为医学与脑科学杂志

Objective To examine cognitive function of the HIV/AIDS patients in the hospitals measured by the neuropsychological tests battery,make an evaluation of cognitive function of the HIV/AIDS patients,and diagnose the patients with HIV-associated neurocognitive disorders(HAND).Methods Ninety-nine normal individuals and two hundred and thirty HIV/AIDS inpatients,who were sampled by multi-stage random stratified in Guangxi,were tested by the 12 items of the neuropsychological tests.Results HIV / AIDS patients with abnormal neuropsychological test entries proportion ranges located between 21.3％-58.7 ％.The results of 12 items of the neuropsychological tests were associated with the results of clinical diagnosis.Among them,the results of SC time,SCW time,color attachment,and numbers of the contiguous error in WSCT tests were positively associated with the results of clinical diagnosis,and the correlation coefficient were 0.384,0.335,0.237 and 0.129,respectively.There was a negative correlation between the results of the rest assessment and the results of clinical diagnosis ; vocabulary fluency was the highest correlation coefficient,while numbers of the contiguous error in WSCT tests was the lowest.Conclusion A higher proportion of abnormal occurrence of Guangxi HIV / AIDS patients in the 12 neuropsychological test entry,and affect the subjects with or without HIV-related neurological assessment of cognitive impairment.The data suggest that a full neuropsychological tests can be better used for the preliminary study of the HIV ±/AIDS patients neurocognitive function.

Prevalência dos déficits cognitivos e avaliação da dependência funcional, do estado nutricional e da qualidade de vida das pessoas convivendo com o HIV em acompanhamento ambulatorial no IPEC / Prevalence of cognitive deficits and evaluation of functional dependency, nutritional status and quality of life of people living with HIV receiving outpatient treatment in IPEC

Objetivos: Determinar a prevalência das alterações cognitivas associadas ao HIV, avaliar a dependência funcional nas atividades da vida diária, o estado nutricional, e os aspectos relacionados à qualidade de vida das pessoas convivendo com o vírus HIV e dos pacientes com AIDS em acompanhamento ambulatorial no IPEC. Métodos: Estudo seccional com pacientes adultos portadores do HIV, selecionados aleatoriamente dos ambulatórios de doenças infecciosas do IPEC/FIOCRUZ. Os participantes foram avaliados no período de novembro de 2009 a novembro de 2010, através dos seguintes instrumentos específicos: Escala Internacional de Demência para HIV (EIDH), Medida de Independência Funcional (MIF), Avaliação Nutricional Subjetiva Global (ANSG) e questionário de qualidade de vida SF-36. Os critérios de exclusão foram históricos de infecção oportunista do SNC, de doença psiquiátrica, de doença neurológica e usuários de drogas. Para fins de comparação incluímos pacientes virgens de tratamento antirretroviral (VTs) e em uso dessas medicações (TARV). Foram realizadas medidas resumo como médias e medianas para as variáveis contínuas e frequências para as variáveis categóricas, além de testes não paramétricos, testes de consistência interna, correlações e de confiabilidade. Um p valor menor do que 0,05 foi considerado significativo para todas as análises estatísticas...

Resultados: Foram incluídos 166 pacientes, mediana de idade de 42 anos (32-50), a maioria homens, 83 pacientes eram VT e 83 pacientes estavam em uso de TARV. A mediana de CD4 era 491 céls/mm 3 para o grupo com TARV e 571 céls/mm 3 para o grupo VT. O estudo mostrou que 28,3% dos pacientes apresentaram alterações cognitivas associadas ao HIV (EIDH≤ 10) e 22,9% possuía algum grau de desnutrição (desnutridos leve a moderado) . Em relação à dependência funcional nas atividades da vida diária, não houve diferença entre os 2 grupos, com a maioria dos participantes mostrando -se independentes (MIF=7) ou pouco dependentes (MIF ≤ 6) nas principais atividades motoras e cognitivas da MIF. Quanto aos aspectos relacionados à saúde geral e ao estado físico e emocional, o estudo mostrou que em ambos os grupos os pacientes tiveram medianas de pontos acima de 60, numa classificação de 0-100 pontos, em todos os domínios do questionário, representado uma boa qualidade de vida. Conclusões: Apesar dos avanços no tratamento antirretroviral, os déficits cognitivos associados ao HIV e a desnutrição ainda são frequentes. Entretanto, tanto os pacientes que fazem uso TARV quanto os VTs mostraram independência funcional na execução das atividades da vida diária e uma boa qualidade de vida...