Abstract：
People with HIV now have near-normal life expectancies due to the success of effective combination antiretroviral therapy (cART). Following cART initiation, immune recovery occurs, and opportunistic diseases become rare. Despite this, high rates of non-infectious comorbidities persist in treated people with HIV, hypothesized to be related to persistent immuno-activation. One such comorbidity is cognitive impairment, which may partly be driven by ongoing neuro-inflammation in otherwise effectively treated people with HIV. In order to develop therapeutic interventions to address neuro-inflammation in effectively treated people with HIV, a deeper understanding of the pathogenic mechanisms driving persistent neuro-inflammatory responses and the ability to better characterize and measure neuro-inflammation in the central nervous system is required. This review highlights recent advances in molecular neuroimaging techniques which have the potential to assess neuro-inflammatory responses within the central nervous system in HIV disease. Proton magnetic resonance spectroscopy (1H-MRS) has been utilized to assess neuro-inflammatory responses since early in the HIV pandemic and shows promise in recent studies assessing different antiretroviral regimens. 1H-MRS is widely available in both resource-rich and some resource-constrained settings and is relatively inexpensive. Brain positron emission tomography (PET) imaging using Translocator Protein (TSPO) radioligands is a rapidly evolving field; newer TSPO-radioligands have lower signal-to-noise ratio and have the potential to localize neuro-inflammation within the brain in people with HIV. As HIV therapeutics evolve, people with HIV continue to age and develop age-related comorbidities including cognitive disorders. The use of novel neuroimaging modalities in the field is likely to advance in order to rapidly assess novel therapeutic interventions and may play a role in future clinical assessments.
摘要：
由于有效的联合抗逆转录病毒疗法（cART）的成功，HIV感染者现在的预期寿命接近正常。启动cART后，免疫恢复发生，机会性疾病变得罕见。尽管如此,在接受治疗的艾滋病毒感染者中，高非传染性合并症的发生率仍然存在，假设与持续的免疫激活有关。其中一种合并症是认知障碍，这可能部分是由正在进行的神经炎症在其他有效治疗的艾滋病毒感染者。为了开发治疗干预措施，以解决有效治疗HIV患者的神经炎症，需要更深入地了解驱动持续性神经炎症反应的致病机制,以及更好地表征和测量中枢神经系统神经炎症的能力.这篇综述强调了分子神经成像技术的最新进展，这些技术有可能评估HIV疾病中枢神经系统内的神经炎症反应。自HIV大流行早期以来，质子磁共振波谱（1H-MRS）已用于评估神经炎症反应，并在评估不同抗逆转录病毒方案的最新研究中显示出希望。1H-MRS在资源丰富和某些资源受限的环境中都可以广泛使用，并且相对便宜。使用转运蛋白（TSPO）放射性配体的脑正电子发射断层扫描（PET）成像是一个快速发展的领域；较新的TSPO放射性配体具有较低的信噪比，并且有可能在HIV感染者的大脑中定位神经炎症。随着HIV疗法的发展，HIV感染者继续衰老并发展与年龄相关的合并症,包括认知障碍.为了快速评估新的治疗干预措施，该领域新的神经影像学模式的使用可能会取得进展，并可能在未来的临床评估中发挥作用。
