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DOI: 10.1055/a-1222-3380
HIV-assoziierte neurokognitive Störungen
HIV-associated neuro-cognitive disordersPublikationsverlauf
Publikationsdatum:
24. August 2020 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00034916/202009/lookinside/thumbnails/10-1055-a-1222-3380-1.jpg)
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.
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