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HIV-assoziierte Neuropathien

HIV-associated neuropathies

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Zusammenfassung

HIV-assoziierte Polyneuropathien sind die häufigste neurologische Manifestation der HIV-Erkrankung und HIV ist weltweit eine der häufigsten Ursachen für Polyneuropathien. Das impliziert, dass HIV in Patienten mit Polyneuropathie immer differenzialdiagnostisch in Betracht gezogen werden sollte. HIV-assoziierte Polyneuropathien stellen ein breites Spektrum an Subformen dar, deren wesentliches gemeinsames Merkmal die konstante Bindung an spezifische Stadien der HIV-Erkrankung ist. Inflammatorische Neuropathien wie das Guillain-Barré-Syndrom (GBS) oder die chronisch inflammatorisch demyelinisierende Polyneuropathie (CIDP) werden typischerweise im Frühstadium der HIV-Infektion diagnostiziert, während beispielsweise die erregerbedingte Polyradikulitis eine Komplikation im AIDS-Stadium darstellt. Die distal-symmetrische Polyneuropathie als Prototyp aller Neuropathien stellt die häufigste Neuromanifestation bei Patienten mit HIV-Infektion dar. Nachfolgende Übersicht fasst die klinischen Manifestationen, die Epidemiologie, Diagnostik, Pathophysiologie und Behandlung HIV-assoziierter Polyneuropathien zusammen.

Summary

Human immunodeficiency virus (HIV)-associated polyneuropathy has become the most common neurological complication of HIV infection and is one of the main risk factors for development of a neuropathy worldwide. Therefore HIV should always be considered as an underlying cause in patients with neuropathy. Many types of peripheral neuropathies are seen in HIV infection depending on the stage of infection. The inflammatory demyelinating neuropathies both acute (Guillain-Barré syndrome, GBS) and chronic (chronic inflammatory demyelinating neuropathy, CIDP) occur mainly at the time of seroconversion or early in the course of the disease while syndromes associated with opportunistic infections like CMV (i.e. polyradiculoneuropathy) occur in the late phase of HIV infection and are related to the loss of immune function. Distal symmetrical polyneuropathy (DSP) is the most common neuropathy in HIV-infected patients. We review the clinical manifestations, epidemiology, clinical diagnostics, pathophysiology and management strategies for HIV-associated polyneuropathies.

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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. Arendt: keine. Hahn: Referentenhonorare von Glaxo, Pfizer, Novartis, Serono.

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Klinik für Neurologie, Charité-Universitätsklinikum, Campus Mitte, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    K. Hahn

  2. Klinik und Poliklinik für Neurologie, Universitätsklinikum Münster, Münster, Deutschland

    I.W. Husstedt

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  1. K. Hahn
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Arendt G für die Deutsche Neuro-AIDS-Arbeitsgemeinschaft (DNAA)

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Correspondence to K. Hahn.

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Hahn K, Husstedt IW und Arendt G für die Deutsche Neuro-AIDS-Arbeitsgemeinschaft (DNAA), Mitglieder der DNAA siehe unter http://www.dnaa.de

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Hahn, K., Husstedt, I. & Arendt G für die Deutsche Neuro-AIDS-Arbeitsgemeinschaft (DNAA). HIV-assoziierte Neuropathien. Nervenarzt 81, 409–417 (2010). https://doi.org/10.1007/s00115-010-2931-x

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