AVANÇOS E DESAFIOS NO MANEJO DO TRANSTORNO NEUROCOGNITIVO ASSOCIADO AO HIV: UMA REVISÃO INTEGRATIVA
DOI:
https://doi.org/10.53843/bms.v10i14.761Keywords:
Demência; Neuroinflamação; Terapia Antirretroviral; Vírus da Imunodeficiência Humana.Abstract
Abstract: Neurodegeneration in HIV-positive patients is a prominent topic in scientific research and medical practice. This condition, characterized by the progressive decline of neurological functions, presents significant challenges for patients and healthcare professionals. The progression of the disease in the Central Nervous System can lead to conditions such as HIV-related dementia and neuropathies. With the increased life expectancy of HIV patients due to Antiretroviral Therapies, new challenges related to quality of life and the emergence of age-related diseases, such as neurodegeneration, have arisen. Objective: To investigate and synthesize current evidence on HIV-Associated Neurocognitive Disorder, underlying mechanisms, and management challenges. Method: This is an integrative review of recent literature sources from the MEDLINE, LILACS, SciELO, and Google Scholar databases. Result: Neuronal dysfunction and neurodegeneration are hallmark features of HIV infection. The early entry of HIV into the central nervous system leads to chronic neuroinflammation, neuronal dysfunction, and neurodegeneration. HIV-Associated Neurocognitive Disorders range from mild to severe, affecting patients' quality of life. Recent advances include the development of antiretroviral therapies with better ability to cross the blood-brain barrier, and the use of adjunctive therapies such as anti-inflammatory and neuroprotective agents, and stem cell therapy, although more studies are needed to confirm their efficacy. Personalized treatment approaches based on pharmacogenomics also show promise. Conclusion: In addition to early diagnosis and proper disease management, the integration of medical care, psychosocial support, and health education strategies is crucial to overcome existing obstacles and explore new therapeutic possibilities. Antiretroviral therapy is crucial for preventing neurodegeneration, but not all antiretrovirals have similar efficacy in the brain.
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References
Ester Almeida Calvacante, Gabriela Machado Dos Santos, Graciana de Sousa Lopes, Jhonata Lima Ferreiral. DISTÚRBIOS NEUROLÓGICOS RELACIONADOS AO HIV. Revista Contemporânea, v. 4, n. 1, p. 350-368, 4 jan. 2024. Disponível em: https://doi.org/10.56083/rcv4n1-018. Acesso em: 9 fev. 2024. DOI: https://doi.org/10.56083/RCV4N1-018
NASCIMENTO, Julio Cesar Matias do et al. Fatores associados às alterações neurocognitivas em pessoas vivendo com HIV maiores de 50 anos. 2022.
SARRALHEIRO, Vitor Alves; GASCÓN, Maria Rita Polo. Autopercepção da qualidade de vida de pessoas com HIV com comprometimento cognitivo. Rev. Faculdade Paulo Picanço, v. 3, n. 2, p. 1-20, 2023. Disponível em: https://doi.org/10.59483/rfpp.v3n2.70. Acesso em: 2 mar. 2024. DOI: https://doi.org/10.59483/rfpp.v3n2.70
Cole JH, Underwood J, Caan MW, De Francesco D, van Zoest RA, Leech R. et al. Aumento do envelhecimento previsto para o cérebro na doença tratada pelo HIV. Neurologia. 2017; 88:1349–1357. DOI: https://doi.org/10.1212/WNL.0000000000003790
Antinori A, Arendt G, Becker JT, Brew BJ, Byrd DA, Cherner M, Clifford DB, Cinque P, Epstein LG, Goodkin K, Gisslen M, Grant I, Heaton RK, Joseph J, Marder K, Marra CM, McArthur JC, Nunn M, Price RW, Pulliam L, Robertson KR, Sacktor N, Valcour V, Wojna VE. Updated research nosology for HIV-associated neurocognitive disorders. Neurology. 2007 Oct 30;69(18):1789-99. DOI: https://doi.org/10.1212/01.WNL.0000287431.88658.8b
Chan P, Valcour V. Neurocognition and the Aging Brain in People With HIV: Implications for Screening. Top Antivir Med. 2022 Dec-Jan;29(5):423-429. PMID: 35191658; PMCID: PMC8862751.
MACKIEWICZ, Miroslaw Mack; Overk Cassia; Achim, Cristian L.; Masliah, Eliezer. Pathogenesis of age-related HIV neurodegeneration. Journal of NeuroVirology, v. 25, n. 5, p. 622-633, 21 fev. 2019. Disponível em: https://doi.org/10.1007/s13365-019-00728-z. Acesso em: 20 jan. 2024. DOI: https://doi.org/10.1007/s13365-019-00728-z
Saylor D., Dickens AM, Sacktor N., Haughey N., Slusher B., Pletnikov M., Mankowski JL, Brown A., Volsky DJ, McArthur JC Transtorno neurocognitivo associado ao HIV – patogênese e perspectivas de tratamento. Nat. Rev. 2016; 12:234–248. DOI: https://doi.org/10.1038/nrneurol.2016.27
Eggers C, Arendt G, Hahn K, Husstedt IW, Maschke M, Neuen-Jacob E, Obermann M, Rosenkranz T, Schielke E, Straube E; Associação Alemã de Neuro-AIDS e NeuroInfectologia (DGNANI). Transtorno neurocognitivo associado ao HIV-1: epidemiologia, patogênese, diagnóstico e tratamento. J Neurol. 2017;264(8):1715- 1727. DOI: https://doi.org/10.1007/s00415-017-8503-2
KALLÁS, Esper Georges; DONINI, Camilla Sunaitis. Perspectivas de cura da infecção pelo HIV. Braz J Infect Dis. 2016; 2(3):162-169.
Roni Robson da Silva, Leandro Andrade da Silva, Maria Virginia Godoy da Silva, Michael Silva Araujo, Milena Preissler das Neves, Marcus Vinicius Lessa de Souza, Elson Santos de Oliveira, Milton Domingues da Silva Junior, Mônica Barreto Ribeirol. Transtornos neurocognitivos e demência relacionados ao HIV em pessoas que fazem uso de antirretroviral: uma revisão integrativa. Research, Society and Development, v. 11, n. 2, p. 47311226039, 3 fev. 2022. Disponível em: https://doi.org/10.33448/rsd-v11i2.26039. Acesso em: 25 janr. 2024. DOI: https://doi.org/10.33448/rsd-v11i2.26039
MAHMUD, Ibrahim Clós; BÓS, Ângelo José Gonçalves. Transtornos cognitivos em idosos vivendo com HIV: uma revisão dos fatores de risco e mecanismos patogênicos. Temas em Saúde, v. 20, n. 1, p. 403-415, 2020. Disponível em: https://doi.org/10.29327/213319.20.1-23. Acesso em: 15 dez. 2023. DOI: https://doi.org/10.29327/213319.20.1-23
CHO, Young-Eun; LEE, Myoung-Hwa Lee; SONG, Byoung-Joon. Neuronal Cell Death and Degeneration through Increased Nitroxidative Stress and Tau Phosphorylation in HIV-1 Transgenic Rats. PLoS One, v. 12, n. 1, p. e0169945, 20 jan. 2017. Disponível em: https://doi.org/10.1371/journal.pone.0169945. Acesso em: 9 jan. 2024. DOI: https://doi.org/10.1371/journal.pone.0169945
MOHAMED, Amina Ali Mohamed; ODUOR, Chrispine Oduor; KINYANJUI, Daniel Kinyanjui. HIV-associated neurocognitive disorders at Moi teaching and referral hospital, Eldoret, Kenya. BMC Neurology. v. 20, n. 1, 14 jul. 2020b. Disponível em: https://doi.org/10.1186/s12883-020-01857-3. Acesso em: 9 dez. 2024. DOI: https://doi.org/10.1186/s12883-020-01857-3
O caminho que põe fim à AIDS: Relatório Global do UNAIDS 2023. Genebra: Programa Conjunto das Nações Unidas sobre HIV/AIDS; 2023. Licença: CC BY-NCSA 3.0 IGO.
Makinson A, Dubois J, Eymard-Duvernay S, Leclercq P, Zaegel-Faucher O, Bernard L, Vassallo M, Barbuat C, Gény C, Thouvenot E, Costagliola D, Ozguler A, Zins M, Simony M, Reynes J, Berr C. Aumento da prevalência de deficiência neurocognitiva em pessoas idosas que vivem com o vírus da imunodeficiência humana: o estudo ANRS EP58 HAND 55-70. Clin Infect Dis. 2020;70(12):2641-2648. DOI: https://doi.org/10.1093/cid/ciz670
SOUZA, Marcus Vinicius Lessa de Souza et al. Access to PrEP by cisgender mens and transsexual person: A qualitative study. RESEARCH, SOCIETY AND DEVELOPMENT, v. 10, n. 1, p. e44310111843.
ANCES, Beau M; LETENDRE, Scott L Letendre. CROI 2019: neurologic complications of HIV disease. Top Antivir Med. 2019; 26-33.
Silva RR da, Silva LA da, Silva MVG da, Neves MP das, Silva MM dos S da, Francisco MTR, Marta CB. Os impactos do Chemsex na saúde pública mundial: um estudo sobre uma perigosa prática sexual entre homens. Saúde Coletiva (Barueri), n. 51, p. 1920-1925, 1 dez. 2019. Disponível em: https://doi.org/10.36489/saudecoletiva.2019v9i51p1920-1925. Acesso em: 20 jan. 2024. DOI: https://doi.org/10.36489/saudecoletiva.2019v9i51p1920-1925
Ned Sacktor, Richard L. Skolasky, Eric Seaberg, Cynthia Munro, James T. Becker, Eileen Martin, Ann Ragin, Andrew Levine, Eric MillerRevis. Prevalence of HIV-associated neurocognitive disorders in the Multicenter AIDS Cohort Study. Neurology, v. 86, n. 4, p. 334-340, 30 dez. 2015. Disponível em: https://doi.org/10.1212/wnl.0000000000002277. Acesso em: 15 dez. 2023. DOI: https://doi.org/10.1212/WNL.0000000000002277
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