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HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors
High rates of mild NCI persist at all stages of HIV infection, despite improved viral suppression and immune reconstitution with CART, and the consistent association of NCI with nadir CD4 across eras suggests that earlier treatment to prevent severe immunosuppression may also help prevent HAND.
Validation of the CNS Penetration-Effectiveness rank for quantifying antiretroviral penetration into the central nervous system.
Poorer penetration of ARV drugs into the CNS appears to allow continued HIV replication in the CNS as indicated by higher CSF HIV viral loads, which is probably critical in treating patients who have HIV-associated neurocognitive disorders.
Natalizumab-associated progressive multifocal leukoencephalopathy in patients with multiple sclerosis: lessons from 28 cases
Continued high prevalence and adverse clinical impact of human immunodeficiency virus-associated sensory neuropathy in the era of combination antiretroviral therapy: the CHARTER Study.
Neuropathic pain and HIV-SN remain prevalent, causing substantial disability and reduced quality of life even with successful CART, and argue for redoubled efforts to determine HIV- SN pathogenesis and the development of symptomatic and neuroregenerative therapies.
Efavirenz concentrations in CSF exceed IC50 for wild-type HIV.
Efavirenz concentrations in the CSF are only 0.5% of plasma concentrations but exceed the wild-type IC(50) in nearly all individuals, and since CSF drug concentrations reflect those in brain interstitial fluids, efvirenz reaches therapeutic concentrations in brain tissue.
Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache
The 2008 AAN guidelines regarding botulinum neurotoxin for blepharospasm, cervical dystonia, headache, and adult spasticity are updated and onaBoNT-A is established as ineffective and should not be offered for episodic migraine and is probably ineffective for chronic tension-type headaches.
Evidence-based review and assessment of botulinum neurotoxin for the treatment of movement disorders.
Asymptomatic HIV-associated neurocognitive impairment increases risk for symptomatic decline
This longitudinal study demonstrates that ANI conveys a 2-fold to 6-fold increase in risk for earlier development of symptomatic HAND, supporting the prognostic value of the ANI diagnosis in clinical settings.
Neurocognitive change in the era of HIV combination antiretroviral therapy: the longitudinal CHARTER study.
- R. Heaton, D. Franklin, I. Grant
- Medicine, PsychologyClinical infectious diseases : an official…
- 1 February 2015
NC change is common in HIV infection and appears to be driven by a complex set of risk factors involving HIV disease, its treatment, and comorbid conditions.
Nucleoside analogue-associated peripheral neuropathy in human immunodeficiency virus infection.
The identification and treatment of peripheral neuropathies associated with use of the nucleoside drugs zalcitabine, didanosine (ddI), and stavudine (d4T) are reviewed.