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JAMA Neurol:HIV感染及抗病毒治疗对患者大脑结构及认知的影响

2017-11-14 zhangfan MedSci原创

研究发现,血清转换早期,HIV感染者认知与大脑结构即以发生变化,持续的抗病毒治疗能预防或减少进行性脑损伤的发生

尽管HIV鸡尾酒疗法可有效控制患者的病情进展,但感染导致的神经认知障碍仍是HIV的严重并发症之一。近日研究人员对HIV感染者接受抗病毒治疗2年后的脑结构变化进行了研究。

在本次纵向病例对照研究中,参与者间隔2年的时间进行神经影像学和神经心理学评估。92名HIV阳性感染者和55名HIV阴性对照组参与,感染者中有48人接受抗病毒治疗。采用多变量混合效应模型评估HIV感染状况对大脑认知能力的影响及随时间的变化趋势。在HIV阳性患者中,利用线性回归模型考察脑体积、认知状态与感染的严重程度和感染时间之间的关系。

所有参与者具有相近的人口统计特征。相比于对照组,HIV阳性感染者多种神经心理测验分数较低:研究测试A (5.9;95% CI,1.5-10.3)、研究测试B (27.3;95% CI,15.0-39.6; P<0.001)、数字符号替换任务 (-12.5;95% CI,-18.9--6.0;P<0.001), 字母数字排序(-2.5;95% CI,-3.7 --1.3), 文字流畅性(-6.6;95% CI,-11.5--1.6), 霍普金斯言语学习-立即回忆测验(-2.4;95% CI,-4.4--0.4)。HIV感染者大脑皮质厚度以及体积小于对照组,组间脑体积随时间的变化趋势无显著差异。

研究发现,血清转换早期,HIV感染者认知与大脑结构即以发生变化,持续的抗病毒治疗能预防或减少进行性脑损伤的发生。

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    2018-01-31 yinhl1978
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    2017-11-16 yahu
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    2017-11-16 wmr116

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