Blood-Brain Barrier Damage in the Context of HIV Infection and Drug Abuse

Human immunodeficiency virus (HIV) infections and intravenous drug use (IVDU) are two linked global health crises since needle sharing is a well-recognized mode of HIV transmission. While HIV-1 infection is the leading cause of death among Americans 25-44 yr old, injection drug use now accounts for about one-third of all new US AIDS cases reported each year. Drug abuse has been suggested to worsen HIV-associated central nervous system (CNS) disease via unknown mechanisms. The brain is a target organ for both, cocaine and HIV-1. Although highly active antiretroviral therapy (HAART) has diminished the incidence of HIV-1-associated dementia, milder forms of neurological disease do persist. Increased survival rates resulting from antiretroviral treatment have led to an increase in the prevalence of HIV-associated neurological disorders (HAND). The basis of HAND however, remains poorly understood.