HIV-associated neurocognitive disorders

Simões, Elizabeth; Justino, J. Daniel

doi:10.1097/01.npr.0000466501.42049.99

Cited by 7 publications

(11 citation statements)

References 28 publications

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“…Other factors have also been shown to contribute to HAND development. For example, factors such as inefficient CNS penetration of cART and/or emergence of latent virus reservoirs can also be attributable factors to the pathogenesis of HAND [11,12]. Additionally, it is now becoming well recognized that HAND is prevalent in infected individuals abusing recreational drugs.…”

Section: Hiv-1 Hand and Cartmentioning

confidence: 99%

HIV‐1, Drug Addiction, and Autophagy

Guo¹,

Periyasamy²,

Buch³

2016

Autophagy in Current Trends in Cellular Physiology and Pathology

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Despite the dramatic success of combined antiretroviral therapies (cART) in controlling peripheral virus replication, the prevalence of HIV-1-associated neurocognitive disorders (HAND) is on a rise as infected individuals continue to live longer. Almost half of the infected individuals on ART develop HAND, out of which at least 30% suffer from a comorbid condition of substance abuse. Involvement of autophagy has been implicated not only in HIV-1 infection of the CNS but also in CNS cells exposed to drugs such as amphetamine, opiates, and cocaine, contributing in turn, to cellular dysfunction. HIV-1 is known to interfere with the autophagy pathway, resulting in turn to upregulation of HIV-1 replication. Specifically, different HIV-1 proteins such as TAT, gp120, and Nef have been shown to act on various stages of autophagy such as initiation and maturation and to affect overall autophagy levels. Whether or not abused drugs and HIV-1 can cooperate to dysregulate autophagy, however, remains unclear. This chapter is focused on identifying the molecular mechanism(s) underlying HIV-1 (proteins) and cocaine, opiate, methamphetamine-mediated impairment of autophagy. Such effects could underlie the synergistic effects of HIV-1 and abused drugs in exacerbating symptoms of HAND.

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Section: Hiv-1 Hand and Cartmentioning

confidence: 99%

HIV‐1, Drug Addiction, and Autophagy

Guo¹,

Periyasamy²,

Buch³

2016

Autophagy in Current Trends in Cellular Physiology and Pathology

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“…In the era of cART, a more discrete form of CNS dysfunction so-called minor cognitive motor disorder (MCMD) has become more common (Brew, 2009; Cohen and Gongvatana, 2009; Sacktor, 2002; Simoes and Justino, 2015). HIV-associated neuropathologies mainly include widespread reactive astrocytes so-called astrocytosis and other changes in the brain depending on the severity of the diseases (Bell et al , 2006; Brew, 2009; Cohen and Gongvatana, 2009; Del Valle and Pina-Oviedo, 2006; Ellis et al , 2007; Gelman, 2015; Sacktor, 2002).…”

Section: Introductionmentioning

confidence: 99%

HIV/neuroAIDS biomarkers

Rahimian

2017

Progress in Neurobiology

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HIV infection often causes neurological symptoms including cognitive and motor dysfunction, which have been collectively termed HIV/neuroAIDS. Neuropsychological assessment and clinical symptoms have been the primary diagnostic criteria for HIV/neuroAIDS, even for the mild cognitive and motor disorder, the most prevalent form of HIV/neuroAIDS in the era of combination antiretroviral therapy. Those performance-based assessments and symptoms are generally descriptive and do not have the sensitivity and specificity to monitor the diagnosis, progression, and treatment response of the disease when compared to objective and quantitative laboratory-based biological markers, or biomarkers. In addition, effects of demographics and comorbidities such as substance abuse, psychiatric disease, nutritional deficiencies, and co-infection on HIV/neuroAIDS could be more readily determined using biomarkers than using neuropsychological assessment and clinical symptoms. Thus, there have been great efforts in identification of HIV/neuroAIDS biomarkers over the past two decades. The need for reliable biomarkers of HIV/neuroAIDS is expected to increase as the HIV-infected population ages and their vulnerability to neurodegenerative diseases, particularly Alzheimer’s disease increases. Currently, three classes of HIV/neuroAIDS biomarkers are being pursued to establish objective laboratory-based definitions of HIV-associated neurologic injury: cerebrospinal fluid biomarkers, blood biomarkers, and neuroimaging biomarkers. In this review, we will focus on the current knowledge in the field of HIV/neuroAIDS biomarker discovery.

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“…Postmortem brain studies conducted in that era indicated that harmful pathology was likely driven directly by viral proteins and neurochemically by secreted neurotoxins and other cellular products (Gelman et al, 2013; Schouten et al, 2011). Later, it was recognized that the virus could persist in CD4+T cells, macrophages, and astrocytes, even in the context of apparently effective cART introduced in the mid-1990s, creating a reservoir of “latent” infection (Deeks, Lewin, & Havlir, 2013; Simoes & Justino, 2015). Subsequently, concerns arose that antiretroviral penetration of the brain was possibly limited and varied between drug classes.…”

mentioning

confidence: 99%

“…However, some controversy continues as to whether neuronal damage occurs as a result of antiretroviral toxicity. Other researchers have reported that NCI can be associated with low CD4+T cell counts, cardiovascular diseases, metabolic disorders, and substance use (Anand, Springer, Copenhaver, & Altice, 2010; Simoes & Justino, 2015; Tedaldi, Minniti, & Fischer, 2015). Current cART is optimized to take into consideration the capacity of the virus to establish latent reservoirs in the brain.…”

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confidence: 99%

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Screening for HIV-Associated Neurocognitive Impairment

Herrmann¹,

McKinnon²,

Skinner³

et al. 2019

Journal of the Association of Nurses in AIDS Care

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Neurocognitive impairment (NCI) is common in people aging with HIV and can adversely affect health-related quality of life. However, early NCI may be largely asymptomatic and neurocognitive function is rarely assessed in the context of routine clinical care. In this study, we considered the utility of two assessment tools as screens for NCI in patients attending a community-based clinic (N = 58; mean age = 57 years): the Montreal Cognitive Assessment (MoCA) and a 3-item cognitive concerns questionnaire derived from the HIV Dementia Scale. Health-related quality of life and depression/anxiety were also measured. Indication of NCI using the MoCA was more prevalent compared to the 3-item questionnaire and was associated with the patients' initial antiretroviral therapy commencing between the years of 1997 and 2001, independently of age. Findings of the MoCA were not confounded by existing mood disorders, unlike the 3-item questionnaire. Therefore, we suggest implementing the MoCA as an initial screen for NCI.

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HIV-associated neurocognitive disorders

Abstract: This review discusses HIV-associated neurocognitive disorders. Practical screening methods are needed for the nurse practitioner to detect neurocognitive impairment in HIV-infected patients.

Cited by 7 publications

References 28 publications

HIV‐1, Drug Addiction, and Autophagy

HIV‐1, Drug Addiction, and Autophagy

HIV/neuroAIDS biomarkers

Screening for HIV-Associated Neurocognitive Impairment

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