Beneficial and Adverse Effects of cART Affect Neurocognitive Function in HIV-1 Infection: Balancing Viral Suppression against Neuronal Stress and Injury.

Journal of Neuroimmune Pharmacology : the Official Journal of the Society on NeuroImmune Pharmacology
Nina Y Yuan, Marcus Kaul

Abstract

HIV-associated neurocognitive disorders (HAND) persist despite the successful introduction of combination antiretroviral therapy (cART). While insufficient concentration of certain antiretrovirals (ARV) may lead to incomplete viral suppression in the brain, many ARVs are found to cause neuropsychiatric adverse effects, indicating their penetration into the central nervous system (CNS). Several lines of evidence suggest shared critical roles of oxidative and endoplasmic reticulum stress, compromised neuronal energy homeostasis, and autophagy in the promotion of neuronal dysfunction associated with both HIV-1 infection and long-term cART or ARV use. As the lifespans of HIV patients are increased, unique challenges have surfaced. Longer lives convey prolonged exposure of the CNS to viral toxins, neurotoxic ARVs, polypharmacy with prescribed or illicit drug use, and age-related diseases. All of these factors can contribute to increased risks for the development of neuropsychiatric conditions and cognitive impairment, which can significantly impact patient well-being, cART adherence, and overall health outcome. Strategies to increase the penetration of cART into the brain to lower viral toxicity may detrimentally increase ARV neurot...Continue Reading

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Citations

Dec 14, 2019·Journal of Neuroimmune Pharmacology : the Official Journal of the Society on NeuroImmune Pharmacology·Shivesh GhuraRebecca L Ashare
Aug 13, 2020·Journal of Neuropathology and Experimental Neurology·Michelle N SullivanJoseph L Mankowski
Mar 11, 2020·BioDrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy·Wanwisa PromsoteAmarendra Pegu
Mar 3, 2021·Journal of Neuroimmune Pharmacology : the Official Journal of the Society on NeuroImmune Pharmacology·Kelly L Jordan-Sciutto
Jun 4, 2021·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Vanessa A GuzmanUNKNOWN Manhattan HIV Brain Bank

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Methods Mentioned

BETA
genotyping

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