Módulo 3 – Curso pós-graduado – VIH e Envelhecimento

Neurocognitive Disorders in HIV Infected Patients

Clinical management of HIV-related neurological disorders

Autor: Prof. Doutor Richard W. Price, MD PhD (San Francisco General Hospital, University of California, San Francisco, USA)

Neurodiagnostic Laboratory Evaluations

Imaging is probably the most useful laboratory tool in diagnosis of brain diseases. It enables one to establish the presence of macroscopic CNS disease and to define its anatomical character. CT is a good approach when an urgent study is required or if there is a suspicion of stroke, but MRI is usually more informative and the most used modality because it provides more definition (indeed, sometimes, it is possible to make a firm diagnosis simply from the MRI characteristics). PET scanning is only rarely useful, largely to confirm a non-AIDS diagnosis of Alzheimer’s disease.

Lumbar puncture (LP) and CSF analysis is not a part of routine HIV care. However, this is a key part of diagnostic evaluation when there is suspicion of a CNS opportunistic infection (such as cryptococcal meningitis or neurosyphilis) or a question of CSF escape (below) in order to establish this diagnosis and define the treatment target in relation to CNS HIV drug resistance. While still largely a research tool, there are times when a biomarker of CNS injury can be helpful. We have done a number of studies of CSF neurofilament light chain (NFL) protein, which appears to be the most sensitive such marker in HIV infection. This should prove more generally applicable when a blood test for NFL becomes clinically available in the future.

Logo MSD Termos de utilização | Política de Privacidade | Sobre a MSD Copyright © 2018 Todos os direitos reservados. Merck Sharp & Dohme Corp.,uma subsidiária da Merck & Co., Inc. Kenilworth, NJ, USA, conhecida fora dos EUA e Canadá como MSD. Os conteúdos disponibilizados nesta página Web são informação de carácter geral e não substituem em nenhum caso as consultas, tratamentos ou as recomendações do seu médico. INFC-1273571-0000 11/2018