Abstract：
Since the identification of human immunodeficiency virus type 1 (HIV-1) in 1983, many improvements have been made to control viral replication in the peripheral blood and to treat opportunistic infections. This has increased life expectancy but also the incidence of age-related central nervous system (CNS) disorders and HIV-associated neurodegeneration/neurocognitive impairment and depression collectively referred to as HIV-associated neurocognitive disorders (HAND). HAND encompasses a spectrum of different clinical presentations ranging from milder forms such as asymptomatic neurocognitive impairment or mild neurocognitive disorder to a severe HIV-associated dementia (HAD). Although control of viral replication and suppression of plasma viral load with combination antiretroviral therapy has reduced the incidence of HAD, it has not reversed milder forms of HAND. The objective of this review, is to describe the mechanisms by which HIV-1 invades and disseminates in the CNS, a crucial event leading to HAND. The review will present the evidence that underlies the relationship between HIV infection and HAND. Additionally, recent findings explaining the role of neuroinflammation in the pathogenesis of HAND will be discussed, along with prospects for treatment and control.
摘要：
自从1983年人类免疫缺陷病毒1型（HIV-1）的鉴定以来，已经进行了许多改进以控制外周血中的病毒复制和治疗机会性感染。这增加了预期寿命,但也增加了年龄相关的中枢神经系统(CNS)病症和HIV相关的神经变性/神经认知损害以及统称为HIV相关的神经认知病症(HAND)的抑郁症的发病率。HAND涵盖一系列不同的临床表现，从较温和的形式，例如无症状的神经认知障碍或轻度的神经认知障碍到严重的HIV相关痴呆（HAD）。尽管联合抗逆转录病毒疗法控制病毒复制和抑制血浆病毒载量降低了HAD的发病率，它没有扭转温和的手的形式。这次审查的目的，是描述HIV-1侵入和传播中枢神经系统的机制，一个关键的事件导致手。该综述将提供HIV感染与HAND之间关系的基础证据。此外,将讨论解释神经炎症在HAND发病机理中的作用的最新发现，以及治疗和控制的前景。
