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Nervenheilkunde 2020; 39(09): 542-547
DOI: 10.1055/a-1222-3380
Schwerpunkt
© Georg Thieme Verlag KG Stuttgart · New York

HIV-assoziierte neurokognitive Störungen

HIV-associated neuro-cognitive disorders
Gabriele Arendt
1   Neuro-Centrum Düsseldorf
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Publication History

Publication Date:
24 August 2020 (online)

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ZUSAMMENFASSUNG

Die HIV-Infektion ist infolge der raschen Entwicklung der antiretroviralen Therapie, als „cART“ = combination antiretroviral treatment bezeichnet, von einer tödlichen Seuche zu einer behandelbaren, chronischen Erkrankung geworden. Dennoch bleiben problematische Aspekte; vor allem die neurologischen Systemmanifestationen (HAND = HIV-associated neurological disorders) stellen weiterhin ein ungelöstes Problem dar. Auch wenn die HIV-assoziierte Demenz in ihrer klassischen Form mit motorischen, kognitiven und emotionalen Defiziten und rascher Progredienz selten geworden ist, bleiben milde Defizite, die gleichwohl die Betroffenen in ihrem Alltag und ihrer Lebensqualität einschränken. Somit ist ein wesentlicher Teil der Betreuung HIV-Positiver, diese Defizite möglichst zu verhindern (früher Therapiebeginn) bzw. früh zu erkennen und zu mildern. Es existiert eine diagnostische Nomenklatur, die Symptomzuordnungen vorgibt, anzuwendende diagnostische Methoden sind festgelegt, die wesentlichen Differenzialdiagnosen beschrieben. An diesen Vorgaben kann sich der in der Behandlung HIV-positiver Patienten unerfahrene Neurologe oder Psychiater orientieren.

ABSTRACT

Due to the rapid development of antiretroviral treatment, described as „cART“ = combination antiretroviral treatment, HIV-infection has changed from a life-threatening epidemic into a chronic treatable disease. However, problematic aspects remain, especially the neurological complications (HAND = HIV-associated neurological disorders) continue to represent an unsolved problem. Even though HIV-associated dementia in its classical form with motor, cognitive and emotional deficits and rapid progression has become rare, mild deficits persist which affect patients quality of life. Thus, it is a major part in HIV-patient care to prevent neuro-cognitive deficits (early treatment start) or at least to detect deficits early and prevent them from getting worse. There is a diagnostic nomenclature describing HAND signs and symptoms, diagnostic methods and the most frequent differential diagnosis. Neurologists and psychiatrists who are not familiar with the management of these patients can find standard operation procedures in the existing literature cited in this article.

Schlüsselwörter

HIV-Infektion - HIV-associated neurological disorders (HAND) - diagnostische Methoden - therapeutische Optionen

Key words

HIV-infection - HIV-associated neurological disorders (HAND) - diagnostic methods - therapeutical options
 

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