ABSTRACT
La infección por el virus de la inmunodeficiencia humana (VIH) puede dar lugar a alteraciones neuropsiquiátricas tales como déficits cognitivos, alteraciones comportamentales o sintomatología psiquiátrica como manía o psicosis secundaria. La evolución y curso pronóstico de los individuos con VIH que presentan comorbilidad psiquiátrica dependerá en gran medida de que se ofrezca un tratamiento adecuado que incluya, por una parte, tratamiento del factor etiológico (VIH) y, por otra, tratamiento de los síntomas psíquicos en cuestión. A partir de la presentación del caso clínico de una paciente con encefalitis en el contexto de una infección por VIH no conocida, que debuta con sintomatología psicótica en forma de trastorno por ideas delirantes de tipo somático, ofrecemos una revisión acerca del manejo de la psicosis en pacientes VIH. Dicha revisión se centra en la epidemiología, etiopatogenia y presentación clínica de la psicosis asociada al VIH así como en el manejo farmacológico recomendado (antirretroviral y antipsicótico) y su particular respuesta al mismo. Ofrecemos al mismo tiempo amplia información acerca de las principales interacciones entre los fármacos antipsicóticos y antirretrovirales que otorgarán al clínico un manejo más adecuado de dichos pacientes
Human immunodeficiency virus (HIV) infection can cause neuropsychiatric disorders such as cognitive impairment, behavioural difficulties or psychiatric symptoms -for instance, mania and psychosis. HIV patients with psychiatric comorbidities need an appropriate treatment which tackles the HIV infection as much as the particular mental symptoms. Here we present the case of a patient suffering from delusions, which turned out to be caused by encephalitis secondary to a previously unknown HIV infection. A review of psychosis in HIV-infected patients is also presented. This review is focused on the epidemiology, etiopathogenesis and clinical presentation of HIV-induced psychosis, as well as the recommended pharmacological treatment (antiretroviral therapy and antipsychotic medication) and the expected treatment response. We also present wide information concerning pharmacological interactions between antiretroviral and antipsychotic medications that we hope will help the clinician to better manage this complex condition
Subject(s)
Humans , Female , Middle Aged , Psychotic Disorders/drug therapy , HIV Infections/complications , Antipsychotic Agents/adverse effects , Anti-Retroviral Agents/adverse effects , Drug Interactions , Protease Inhibitors/adverse effects , Risk FactorsABSTRACT
Human immunodeficiency virus (HIV) infection can cause neuropsychiatric disorders such as cognitive impairment, behavioural difficulties or psychiatric symptoms –for instance, mania and psychosis. HIV patients with psychiatric comorbidities need an appropriate treatment which tackles the HIV infection as much as the particular mental symptoms. Here we present the case of a patient suffering from delusions, which turned out to be caused by encephalitis secondary to a previously unknown HIV infection. A review of psychosis in HIV-infected patients is also presented. This review is focused on the epidemiology, etiopathogenesis and clinical presentation of HIV-induced psychosis, as well as the recommended pharmacological treatment (antiretroviral therapy and antipsychotic medication) and the expected treatment response. We also present wide information concerning pharmacological interactions between antiretroviral and antipsychotic medications that we hope will help the clinician to better manage this complex condition.
