HIV相关痴呆的发病机制及药物治疗靶点

Pathogenesis of HIV-associated dementia and its potential drug targets

随着艾滋病（acquired immune deficiency syndrome,AIDS）的全球性暴发流行,HIV相关神经系统功能障碍,主要为HIV相关痴呆（HIV-associateddementia,HAD）和更加严重的HIV相关神经认知紊乱（HIV-associated neurocognitive disorders,HAND）,逐渐被人们所认识并研究。HAD为艾滋病晚期的一种神经系统并发症,病人表现为认知和行为功能障碍、性格改变、短期记忆丧失等。目前认为,HAD将在全球范围内成为40岁左右人群痴呆的主要原因,并成为艾滋病患者一个重要的独立死亡因素,从而带来系列的社会问题。虽然高效抗逆转录病毒治疗方法（highly active antiretroviral therapy,HAART）在临床上的广泛应用使HAD的发病率有所下降,

HIV-associated dementia（HAD）is a serious complication of AIDS patients.With the wide application of highly active antiretroviral therapy（HAART）,the replication of HIV is under effective control and the incidence of HAD is also declined.However,a relatively mild HIV-associated symptom of dementia,called minor cognitively motor disorder（MCMD）,become the problem and can not be neglected in the treatment of AIDS.The neural injury caused by HIV may be mediated mainly by macrophages,microglia and astrocytes,though we can not rule out the direct damage on neurons by HIV proteins.To date,the precise mechanism of neural damage caused by HIV remains unclear.The present review tries to figure out the recent progress of pathogenesis and potential drug targets for HAD.