Die hochaktive antiretrovirale Therapie

Zusammenfassung

Nebenwirkungen der hochaktiven antiretroviralen Therapie (HAART) zur Behandlung der HIV-Infektion werden insbesondere als Polyneuropathie klinisch manifest. Die Substanzen ddI, ddC und d4T gelten als besonders neurotoxisch. Es wurden ereigniskorrelierte Potenziale (EKP) von Patienten, die HAART mit ddI, ddC oder d4T erhielten, analysiert und mit einer Kontrollgruppe gleichen Stadiums ohne diese Substanzen verglichen. In der Gruppe mit ddI, ddC oder d4T waren mehr Patienten, die unter einer HIV-assoziierten neurokognitiven Störung oder distalsymmetrischen Polyneuropathie litten (p ≥ 0,01). Patienten unter der Therapie mit ddI, ddC oder d4T wiesen eine signifikante Verlängerung der Komponente P3 der EKP (p ≥ 0,02) auf. In Übereinstimmung mit der Literatur weisen diese Ergebnisse darauf hin, dass unter der Therapie mit ddI, ddC und d4T zusätzlich kognitive Beeinträchtigungen hervorgerufen werden. Möglicherweise liegt diesen Veränderungen eine Auswirkung von ddI, ddC und d4T auf die Funktion der Mitochondrien im ZNS zugrunde.

Summary

The highly active antiretroviral therapy (HAART) can cause peripheral neuropathy. In this study, the impact of specific substances of HAART on neurocognitive function during HIV infection was measured. Event-related potentials (ERP) from patients receiving (HAART) with ddI, ddC, or d4T were compared to a control group without any of these three substances. More patients suffering from neurocognitive disorders and peripheral neuropathy were found in the patients receiving ddI, ddC, or d4T (p ≥ 0.01). Patients treated with ddI, ddC, or d4T showed a significant increase of the latency of the P3 component (p ≥ 0.02). In accordance to the literature, these results indicate that ddI, ddC, and d4T represent an additional factor in the development of HIV associated neurocognitive disorder besides the HIV infection itself. It is assumed that these alterations are induced by the toxic impact of ddI, ddC and d4T on γ-polymerase of the mitochondrias in the central nervous system.

Schlüsselwörter

HIV-Infektion - HAART - neurokognitive Störung

Keywords

HIV infection - HAART - neurocognitive disorder

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