DIAGNOSTICS AND MECHANISMS OF THE DAMAGE OF THE CENTRAL NERVOUS SYSTEM IN HIV-INFECTION
The article describes basic mechanisms of central nervous system damage as well as HIV transmission through physiological barriers, its interaction with brain cells containing receptors CD4 and co-receptors ССR-5 and CXCR 4. A description has been given to participation of various chemical ingredients(proinflammatory cytokines, metabolites, immune complexes, HIV toxic proteins and etc.) in brain damage, development of clinical presentations of neurologic and cognitive disorders from light HIV associated neurocognitive disorders to dementia and severe neurologic syndromes, whose formation takes up to several years. It has been shown that the early stages of infection already reveal considerable glucose metabolism disorders, changes in EEG with evoked potentials, which may become an additional marker of HIV infection. Along with the description of radiological and clinical methods of examination, differences in HIV quantity and genetics have been shown as related to blood and cerebrospinal fluid with various resistances to medicines. Well-timed and adequate anti - retroviral therapy accompanied with the choice of medicines with high degree of penetration through blood-brain barrier can in most cases promote prevention, delay and reduction of brain damage intensity as part of combined therapy of HIV infected patients.