HIV-1 neuroimmunity in the era of antiretroviral therapy

Stephanie D. Kraft-Terry, Andrew R. Stothert, Shilpa Buch, Howard E. Gendelman

Research output: Contribution to journalReview articlepeer-review

60 Scopus citations

Abstract

Human immunodeficiency virus type 1 (HIV-1)-associated neurocognitive disorders (HAND) can affect up to 50% of infected people during the disease course. While antiretroviral therapies have substantively increased the quality of life and reduced HIV-1-associated dementia, less severe minor cognitive and motor deficits continue. Trafficking of HIV-1 into the central nervous system (CNS), peripheral immune activation, dysregulated glial immunity, and diminished homeostatic responses are the disease-linked pathobiologic events. Monocyte-macrophage passage into the CNS remains an underlying force for disease severity. Monocyte phenotypes may change at an early stage of cell maturation and immune activation of hematopoietic stem cells. Activated monocytes are pulled into the brain in response to chemokines made as a result of glial inflammatory processes, which in turn, cause secondary functional deficits in neurons. Current therapeutic approaches are focused on adjunctive and brain-penetrating antiretroviral therapies. These may attenuate virus-associated neuroinflammatory activities thereby decreasing the severity and frequency of HAND.

Original languageEnglish (US)
Pages (from-to)542-548
Number of pages7
JournalNeurobiology of Disease
Volume37
Issue number3
DOIs
StatePublished - Mar 2010

Keywords

  • Adaptive immunity
  • Adjunctive therapies
  • Blood-brain barrier
  • Chemokines
  • Cognitive dysfunction
  • HIV-1-associated neurocognitive disorders
  • Hematopoietic stem cells
  • Innate immunity
  • Microglia
  • Neuroinflammation
  • Proinflammatory cytokines

ASJC Scopus subject areas

  • Neurology

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