r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2022-27-5-5-13r-n-j-354Research ArticleОБЗОРЫREVIEWSСовременный взгляд на профилактику и лечение ВИЧ-ассоциированных нейрокогнитивных нарушенийA modern view on the prevention and treatment of HIV-associated neurocognitive disordershttps://orcid.org/0000-0003-4012-2523ЕгороваЕ. А.EgorovaE .A.

 Симферополь 

 Simferopol 

egorovapharm@mail.ruhttps://orcid.org/0000-0003-0725-5455УсеиноваА. Н.UseinovaA. N.

Симферополь

 Simferopol 

mametova.as@mail.ruhttps://orcid.org/0000-0001-9144-7681АбибулаевС. А.AbibulaevS. A.

 Симферополь 

 Simferopol 

abibserdar@gmail.comhttps://orcid.org/0000-0003-0765-5336МарьяненкоС. П.Mar'yanenkoS. P.

 Симферополь 

 Simferopol 

sofiya-maryanenko@mail.ruhttps://orcid.org/0000-0003-1571-9301КоряноваК. Н.KoryanovaK. N.

 Пятигорск 

 Pyatigorsk 

kskor-16@mail.ruИнститут «Медицинская академия им. С.И. Георгиевского» ФГАОУ ВО «КФУ им. В.И. Вернадского»РоссияInstitute “Medical Academy n.a. S.I. Georgievsky” of Vernadskjy CFURussian FederationПятигорский медико-фармацевтический институт, филиал ФГБОУ ВО «Волгоградский государственный медицинский университет» Минздрава РоссииРоссияPyatigorsk Medical and Pharmaceutical Institute, Branch of the Federal State Budgetary Educational Institution of Higher Education “Volgograd State Medical university” of the Ministry of Health of the Russian FederationRussian Federation202223112022275513Copyright © Егорова Е.А., Усеинова А.Н., Абибулаев С.А., Марьяненко С.П., Корянова К.Н., 20222022Егорова Е.А., Усеинова А.Н., Абибулаев С.А., Марьяненко С.П., Корянова К.Н.Egorova E..., Useinova A.N., Abibulaev S.A., Mar'yanenko S.P., Koryanova K.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/354

Синдром приобретенного иммунодефицита считается одной из самых глобальных пандемий в истории человечества. Несмотря на использование высокоактивной антиретровирусной терапии, инфицирование пациента вирусом иммунодефицита человека-1 достаточно часто сопровождается развитием нарушений со стороны центральной нервной системы, в том числе нейрокогнитивных функций. Применение этиологической терапии позволяет успешно предотвратить развитие многих из возможных терминальных осложнений заболевания, однако с увеличением времени выживания пациентов распространенность когнитивных нарушений среди пациентов со СПИДом растет. Клинические проявления таких нарушений могут быстро прогрессировать от легких расстройств концентрации внимания до развития деменции. Как правило, диагностика нейрокогнитивных нарушений у ВИЧ-инфицированных пациентов представляет определенные сложности и требует от врача последовательного проведения диагностических процедур с применением первичного скрининга и при необходимости психологического тестирования и нейровизуализации. Залогом успешного лечения являются своевременная диагностика и коррекция нейрокогнитивных нарушений у ВИЧ-инфицированных на фоне адекватной антиретровирусной терапии. В обзоре рассматриваются возможности применения лекарственных препаратов с целью профилактики и лечения нейрокогнитивных нарушений с учетом особенностей персистенции возбудителя в нервной системе и возможностей современной медицины. Одним из наиболее перспективных методов поддерживающей терапии подобных нарушений является доставка антиретровирусных препаратов с использованием различных наносистем (полимерные наночастицы, липидные наночастицы, наногели, магнитные частицы).

Acquired Immune Deficiency Syndrome (AIDS) is now considered one of the most global pandemics in human history. Despite the use of highly active antiretroviral therapy (HAART), HIV-1 infection is often accompanied by the development of CNS disorders, including neurocognitive disorders. The use of etiologic therapy has successfully prevented many of the possible terminal complications of the disease, but as patient survival time increases, the prevalence of cognitive impairment among AIDS patients is increasing. Theclinical manifestations of these disorders can rapidly progress from subtle attention deficits and behavioral disorders to the development of dementia. Diagnosing neurocognitive impairment in HIV-infected patients is usually difficult and requires consistent diagnostic procedures from the clinician, including initial screening and, if necessary, neuropsychiatric testing and neuroimaging. Early diagnosis and correction of neurocognitive impairment in HIV-infected individuals with adequate antiretroviral therapy is essential for successful treatment. The review also considers the use of drugs for the prevention and treatment of neurocognitive impairment, taking into account the peculiarities of persistence of the pathogen in the nervous system and the capabilities of modern medicine. One of the most promising methods of supporting therapy for such disorders is the delivery of antiretroviral drugs using various nanosystems (polymeric nanoparticles, lipid nanoparticles, nanogels, magnetic particles).

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The authors declare that there are no conflicts of interest present.