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Neurology：HIV感染者 早诊早治有助减少神经认知损害

2013-02-06 CMT李妍 编译 CMT李妍 编译

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　　美国一项研究显示，人类免疫缺陷病毒（HIV）感染者，在感染早期获得诊治，神经认知功能损害（NCI）发生率与未感染者相当。论文发表于《神经病学》[Neurology 2013，80（4）：371]杂志。 　　研究纳入200例HIV感染者（HIV+，中位年龄36岁，中位感染时间为5年），以及50名匹配 对照（HIV-）。HIV+被分为感染早期（感染＜6年，无艾滋病相关表现，最

　　美国一项研究显示，人类免疫缺陷病毒（HIV）感染者，在感染早期获得诊治，神经认知功能损害（NCI）发生率与未感染者相当。论文发表于《神经病学》[Neurology 2013，80（4）：371]杂志。

　　研究纳入200例HIV感染者（HIV+，中位年龄36岁，中位感染时间为5年），以及50名匹配 对照（HIV-）。HIV+被分为感染早期（感染＜6年，无艾滋病相关表现，最低CD4细胞计数＞200/mm3，n=100）和晚期（n=100）两组，均获得早期诊断和治疗。当前64%在接受高效抗逆转录病毒治疗（在诊断后1.3年、中位CD4计数333/mm3时开始）。

　　结果为，共38例HIV+者（19%）发生NCI ，发生率在早期和晚期HIV感染者中相当（18%对20%，P=0.72），且与HIV-者NCI发生率相当。


Objective: To describe the prevalence of neurocognitive impairment (NCI) among early diagnosed and managed HIV-infected persons (HIV+) compared to HIV-negative controls.
Methods: We performed a cross-sectional study among 200 HIV+ and 50 matched HIV-uninfected (HIV−) military beneficiaries. HIV+ patients were categorized as earlier (<6 years of HIV, no AIDS-defining conditions, and CD4 nadir >200 cells/mm3) or later stage patients (n = 100 in each group); both groups were diagnosed early and had access to care. NCI was diagnosed using a comprehensive battery of standardized neuropsychological tests.
Results: HIV+ patients had a median age of 36 years, 91% were seroconverters (median window of 1.2 years), had a median duration of HIV of 5 years, had a CD4 nadir of 319, had current CD4 of 546 cells/mm3, and 64% were on highly active antiretroviral therapy (initiated 1.3 years after diagnosis at a median CD4 of 333 cells/mm3). NCI was diagnosed among 38 (19%, 95% confidence interval 14%–25%) HIV+ patients, with a similar prevalence of NCI among earlier and later stage patients (18% vs 20%, p = 0.72). The prevalence of NCI among HIV+ patients was similar to HIV− patients.
Conclusions: HIV+ patients diagnosed and managed early during the course of HIV infection had a low prevalence of NCI, comparable to matched HIV-uninfected persons. Early recognition and management of HIV infection may be important in limiting neurocognitive impairment.

    

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    2013-04-28 yinhl1978

    #Neurol#

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    2013-02-08 circumcision

    #HIV感染者#

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    2013-02-08 zsyan

    #早诊早治#

    0

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    2013-02-08 szhvet

    #神经认知#

    0

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