Der Nervenarzt

, 80:1133 | Cite as

Hochaktive antiretrovirale Therapie bei Neuro-AIDS

Nebenwirkungen auf das Nervensystem und Interaktionen
  • I.W. Husstedt
  • D. Reichelt
  • E. Neuen-Jakob
  • K. Hahn
  • F. Kästner
  • R. von Einsiedel
  • B. Vielhaber
  • G. Arendt
  • S. Evers
Übersichten

Zusammenfassung

Die hochaktive antiretrovirale Therapie (HAART) hat zu einer mittleren Überlebenszeit im AIDS-Stadium von mehr als 10 Jahren geführt. In der Zwischenzeit sind 5 Substanzgruppen bekannt, von denen die Integraseinhibitoren und die CCR5-Antagonisten zu den neuesten und modernsten Medikamenten gehören. Die lange Überlebenszeit im AIDS-Stadium führt dazu, dass Nebenwirkungen und Interaktionen von HAART mehr in den Vordergrund treten und bezüglich der differenzialdiagnostischen Auswirkungen gegenüber den Symptomen der HIV-Infektion selbst abgegrenzt werden müssen. Nebenwirkungen von HAART betreffen das zentrale und periphere Nervensystem sowie die Muskulatur, die Neurotoxizität der einzelnen Komponenten von HAART ist substanzspezifisch außerordentlich unterschiedlich. Kenntnisse der Interaktionen von Retrovirustatika mit Neuropsychopharmaka wie Antiepileptika, Antidepressiva und Analgetika sind bei der Behandlung von Patienten mit Neuro-AIDS essenziell.

Schlüsselwörter

HAART Neurotoxizität Zentrales und peripheres Nervensystem Interaktionen 

Highly active antiretroviral therapy of neuro-AIDS

Side effects on the nervous system and interactions

Summary

Highly active antiretroviral therapy (HAART) has increased the mean survival time in the AIDS stage to sometimes more than 10 years. Five different groups of antiretroviral medications are known, of which integrase inhibitors and CCR5 antagonists represent the newest and most modern substances. The long AIDS survival time implies that side effects and interactions become relatively more important and must be differentiated from the symptoms of HIV itself. Side effects of HAART concern the central and peripheral nervous system and the muscles. The neurotoxicity of the components in HAART varies considerably and depends on the substance itself. Knowledge of side effects and interactions of HAART with antiepileptics, antidepressants, and analgetics are essential for the treatment of patients with neuro-AIDS.

Keywords

Highly active antiretroviral therapy Neurotoxicity Central and peripheral nervous system Interactions 

Notes

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Husstedt: Advisory Board der Fa. Boehringer, BMS; Referentenhonorare von Astra, Boehringer, BMS, GSK, Gilead, Pfizer, Grünenthal, MSD, Behring, Forschungsförderung von Gilead für Investigator initiated study. Reichelt: Referentenhonorare von Boehringer, GSK, Gilead, Roche. Hahn: Referentenhonorare von Glaxo, Pfizer, Novartis, Serono. Arendt: Referentenhonorare von GSK, Gilead, Roche; Forschungsförderung von Gilead für Investigator initiated study. Evers: Grants und Referentenhonorare Allergan, Berlin Chemie, Boehringer, Desitin, Dysport, Eisai, GSK, MSD, Novartis, Pfizer, UCB, Weber & Webwer.

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Copyright information

© Springer Medizin Verlag 2009

Authors and Affiliations

  • I.W. Husstedt
    • 1
  • D. Reichelt
    • 2
  • E. Neuen-Jakob
    • 3
  • K. Hahn
    • 4
  • F. Kästner
    • 5
  • R. von Einsiedel
    • 6
  • B. Vielhaber
    • 7
  • G. Arendt
    • 8
  • S. Evers
    • 1
  1. 1.Klinik und Poliklinik für Neurologie, Neuro-Aids-AmbulanzUniversitätsklinikumMünsterDeutschland
  2. 2.Klinik und Poliklinik für Innere Medizin DUniversitätsklinikumMünsterDeutschland
  3. 3.Institut für NeuropathologieUniversitätsklinikumDüsseldorfDeutschland
  4. 4.Neurologische KlinikCharité BerlinBerlinDeutschland
  5. 5.Klinik und Poliklinik für Psychiatrie und PsychotherapieUniversitätsklinikumMünsterDeutschland
  6. 6.Psychiatrische AbteilungAsklepios-KlinikLangenDeutschland
  7. 7.Die WerkstattBerlinDeutschland
  8. 8.Klinik für NeurologieUniversitätsklinikumDüsseldorfDeutschland

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