Neuropsychiatric sequelae of medication non-adherence in people living with HIV

IF 0.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL AIMS Medical Science Pub Date : 2023-01-01 DOI:10.3934/medsci.2023014
D. Moreira, R. Khan, P. Sales
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Abstract

Non-adherence to anti-retroviral therapy (cART) among people living with HIV/AIDS (PLWHA) is complex, multifactorial, and leads to increases in viral load, immunosuppression, and HIV burden related to direct CNS virulence and cART re-initiation (i.e., immune reconstitution syndrome). Among behavioral disturbances, which may become long-lasting without proper treatment, major depressive disorder, generalized anxiety disorder, schizophrenia, and bipolar spectrum disorders are frequent, as well as exacerbation of other premorbid underlying psychiatric conditions, such as post-traumatic stress disorder (PTSD) and substance use and related conditions, not to mention neurocognitive disorders that are encompassed under the umbrella term of HIV-Associated Neurocognitive Disorders (HAND). In this review, we summarized the neuropsychiatric sequelae of medication non-adherence in PLWHA by utilizing two clinical vignettes to illustrate how syndemic factors may interact and lead to unique presentations.
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艾滋病毒感染者药物不依从性的神经精神后遗症
艾滋病毒/艾滋病感染者(PLWHA)不坚持抗逆转录病毒治疗(cART)是复杂的、多因素的,并导致病毒载量增加、免疫抑制和与中枢神经系统直接毒力和cART重新启动(即免疫重建综合征)相关的艾滋病毒负担。在行为障碍中,如果没有适当的治疗,可能会持续很长时间,重度抑郁症、广泛性焦虑症、精神分裂症和双相情感障碍是常见的,以及其他病前潜在精神疾病的恶化,如创伤后应激障碍(PTSD)和物质使用及相关疾病。更不用说在hiv相关神经认知障碍(HAND)的总称下包含的神经认知障碍。在这篇综述中,我们总结了PLWHA患者药物依从性不良的神经精神后遗症,通过两个临床小插曲来说明综合征因素如何相互作用并导致独特的表现。
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来源期刊
AIMS Medical Science
AIMS Medical Science MEDICINE, RESEARCH & EXPERIMENTAL-
自引率
14.30%
发文量
20
审稿时长
12 weeks
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