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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">aids</journal-id><journal-title-group><journal-title xml:lang="ru">ВИЧ-инфекция и иммуносупрессии</journal-title><trans-title-group xml:lang="en"><trans-title>HIV Infection and Immunosuppressive Disorders</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2077-9828</issn><publisher><publisher-name>Baltic Medical Education Center</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.22328/2077-9828-2018-10-4-7-24</article-id><article-id custom-type="elpub" pub-id-type="custom">aids-388</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ЛЕКТОРИЙ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LECTURE</subject></subj-group></article-categories><title-group><article-title>ВИЧ-АССОЦИИРОВАННЫЕ НЕЙРОКОГНИТИВНЫЕ НАРУШЕНИЯ: ДИАГНОСТИКА, ВЫЯВЛЕНИЕ ПРИЧИН И ЭФФЕКТИВНОСТЬ ТЕРАПИИ</article-title><trans-title-group xml:lang="en"><trans-title>HIV-ASSOCIATED NEUROCOGNITIVE DISORDERS: DIAGNOSIS, DETECTION OF CAUSES AND THERAPY EFFICIENCY</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Трофимова</surname><given-names>Т. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Trofimova</surname><given-names>T. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Трофимова Татьяна Николаевна</p><p>д.м.н., профессор кафедры рентгенологии и радиологии </p><p>г.н.с. </p><p>в.н.с. отдела экологической физиологии </p><p>197376, Санкт-Петербург, ул. Академика Павлова, 12</p></bio><email xlink:type="simple">Trofimova-TN@avaclinic.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Катаева</surname><given-names>Г. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Katayeva</surname><given-names>G. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Катаева Галина Вадимовна — к.б.н., зам. директора по научной работе</p><p>197376, Санкт-Петербург, ул. Академика Павлова, 9</p></bio><email xlink:type="simple">galina@ihb.spb.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Громова</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Gromova</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Громова Елена Анатольевна — к.м.н., врач-рентгенолог, зав. отделением лучевой диагностики</p><p>197376, Санкт-Петербург, ул. Академика Павлова, 9,</p><p>e-mail: gromova@ihb.spb.ru</p></bio><email xlink:type="simple">79118187464@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рассохин</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Rassokhin</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рассохин Вадим Владимирович</p><p>д.м.н., профессор кафедры социально-значимых инфекций </p><p>в.н.с. </p><p>в.н.с. отдела экологической физиологии </p><p>197376, Санкт-Петербург, ул. Академика Павлова, 12</p></bio><email xlink:type="simple">ras-doc@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Боева</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Boeva</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Боева Екатерина Валериевна — клинический ординатор кафедры социально-значимых инфекций</p><p>зав. отделением хронической вирусной инфекции Северо-Западного окружного центра по профилактике и борьбе со СПИД </p><p>врач-инфекционист </p><p>197101, Санкт-Петербург, ул. Мира, 14</p></bio><email xlink:type="simple">kathrine.boeva@gmail.com</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Симакина</surname><given-names>О. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Simakina</surname><given-names>O. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Симакина Ольга Евгеньевна — к.б.н., н.с. лаборатории хронических вирусных инфекций отдела экологической физиологии</p><p>197376, Санкт-Петербург, ул. Академика Павлова, 12</p></bio><email xlink:type="simple">r154ao@gmail.com</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Беляков</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Belyakov</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Беляков Николай Алексеевич — д.м.н., профессор, академик РАН, з.д.н. РФ, зав. кафедрой социально-значимых инфекций </p><p>г.н.с.</p><p>руководитель Северо-Западного окружного центра по профилактике и борьбе со СПИД </p><p>197101, Санкт-Петербург, ул. Мира, 14</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБУН «Институт мозга человека им. Н.П.Бехтеревой» РАН; &#13;
ФГБУН «Институт экспериментальной медицины»;&#13;
ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет имени академика И.П.Павлова» МЗ РФ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.M.Bekhterev National Medical Research Center of Psychiatry and Neurology;&#13;
FSBSI «IEM»;&#13;
FSBSI HE I.P.Pavlov SPbSMU MON Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУН «Институт мозга человека им. Н.П.Бехтеревой» РАН</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.M.Bekhterev National Medical Research Center of Psychiatry and Neurology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБУН «Институт экспериментальной медицины»;&#13;
ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет имени академика И.П.Павлова» МЗ РФ; &#13;
ФБУН «Санкт-Петербургский НИИ эпидемиологии и микробиологии имени Пастера»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>FSBSI «IEM»;&#13;
FSBSI HE I.P.Pavlov SPbSMU MON Russia; &#13;
Saint-Petersburg Pasteur Institute</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет имени академика И.П.Павлова» МЗ РФ; &#13;
ФБУН «Санкт-Петербургский НИИ эпидемиологии и микробиологии имени Пастера»; &#13;
ГКУЗ ЛО «Центр по профилактике и борьбе со СПИД и инфекционными заболеваниями»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>FSBSI HE I.P.Pavlov SPbSMU MON Russia; &#13;
Saint-Petersburg Pasteur Institute;&#13;
Leningrad regional Center for prevention and control of AIDS and infectious diseases</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ФГБУН «Институт экспериментальной медицины»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>FSBSI «IEM»</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>16</day><month>01</month><year>2019</year></pub-date><volume>10</volume><issue>4</issue><fpage>7</fpage><lpage>24</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Трофимова Т.Н., Катаева Г.В., Громова Е.А., Рассохин В.В., Боева Е.В., Симакина О.Е., Беляков Н.А., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Трофимова Т.Н., Катаева Г.В., Громова Е.А., Рассохин В.В., Боева Е.В., Симакина О.Е., Беляков Н.А.</copyright-holder><copyright-holder xml:lang="en">Trofimova T.N., Katayeva G.V., Gromova E.A., Rassokhin V.V., Boeva E.V., Simakina O.E., Belyakov N.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://hiv.bmoc-spb.ru/jour/article/view/388">https://hiv.bmoc-spb.ru/jour/article/view/388</self-uri><abstract><p>В лекции, подготовленной для врачей различного профиля, систематизированы сведения о наиболее важных механизмах поражения головного мозга при ВИЧ-инфекции, частоте развития нейрокогнитивных нарушений и их роли в инвалидизации больных, даны классификации этих нарушений. Представлены возможности и важность экспресс-диагностики и углубленного обследования пациентов для постановки развернутого клинического диагноза и назначения эффективной терапии. Значительное внимание уделено влиянию иммуносупрессии, вовлечению клеточных элементов головного мозга и формирования резервуара ВИЧ в патогенез нейрокогнитивных нарушений. Обсуждаются особенности проведения радиологических исследований, включая магнитно-резонансную томографию, магнитно-резонансную спектроскопию для оценки метаболизма и тканевой перфузии посредством применения ряда химических маркеров. Определены подходы к профилактике, диагностике и терапии с учетом стадии заболевания. Сформулирован алгоритм выявления и диагностики когнитивных нарушений, показана значимость различных диагностических методов на различных этапах ВИЧ-инфекции, в том числе при ВИЧ-ассоциированных заболеваниях.</p></abstract><trans-abstract xml:lang="en"><p>The lecture intended for general practitioners represents collated information on the most important mechanisms of brain damage under HIV infection, the rate of neurocognitive disorders and their role in disability of patients, classification of these disorders. The capabilities and importance of diagnosis and an in-depth work-up of patients for establishing complete clinical diagnosis and order of effective treatment are presented in the lecture. Much attention is given to immunosuppression influence, brain cell elements involvement and forming of reservoir of HIV infection in pathogenesis of neurocognitive diseases. The lecture describes special aspects of radiology examinations including magnetic resonance imaging, magnetic resonance spectroscopy for assessment of metabolism and tissue perfusion using some chemical markers. Approaches to prevention, diagnosis and treatment are provided taking into account the stage of a disease. An algorithm of detection of causes and diagnosis of cognitive disorders is stated in the lecture and the role of different diagnostic approaches at different stages of HIV infection including HIV-associated diseases is shown.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ВИЧ-инфекция</kwd><kwd>поражение головного мозга</kwd><kwd>нейрокогнитивные расстройства</kwd><kwd>диагностика</kwd><kwd>профилактика</kwd><kwd>лечение</kwd></kwd-group><kwd-group xml:lang="en"><kwd>HIV infection</kwd><kwd>brain damage</kwd><kwd>neurocognitive disorders</kwd><kwd>diagnosis</kwd><kwd>prevention</kwd><kwd>treatment</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Grant I., Atkinson J.H., Hesselink J.R., Kennedy C.J., Richman D.D., Spector S.A., McCutchan J.A. 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