Cognitive impairment in patients with AIDS - prevalence and severity.
TLDR
The severity and prevalence of the neuropsychiatric complications of HIV including delirium, neurobehavioral impairments (depression), minor cognitive-motor dysfunction, and HIV-associated dementia are reviewed.Abstract:
The advent of highly active antiretroviral therapy has prolonged the life expectancy of HIV patients and decreased the number of adults who progress to AIDS and HIV-associated dementia. However, neurocognitive deficits remain a pronounced consequence of HIV/AIDS. HIV-1 infection targets the central nervous system in subcortical brain areas and leads to high rates of delirium, depression, opportunistic central nervous system infections, and dementia. Long-term HIV replication in the brain occurs in astrocytes and microglia, allowing the virus to hide from antiviral medication and later compromise neuronal function. The associated cognitive disturbance is linked to both viral activity and inflammatory and other mediators from these immune cells that lead to the damage associated with HIV-associated neurocognitive disorders, a general term given for these disturbances. We review the severity and prevalence of the neuropsychiatric complications of HIV including delirium, neurobehavioral impairments (depression), minor cognitive-motor dysfunction, and HIV-associated dementia.read more
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The Microbiota-Gut-Brain Axis
John F. Cryan,Kenneth J. O’Riordan,Caitlin S. M. Cowan,Kiran V. Sandhu,Thomaz F.S. Bastiaanssen,Marcus Boehme,Martín Gabriel Codagnone,Sofia Cussotto,Christine Fülling,Anna V. Golubeva,Katherine E. Guzzetta,Minal Jaggar,Caitriona M. Long-Smith,Joshua M. Lyte,Jason A. Martin,Alicia Molinero-Perez,Gerard M. Moloney,Emanuela Morelli,Enrique Morillas,Rory C. O'Connor,Joana S Cruz-Pereira,Veronica L. Peterson,Kieran Rea,Nathaniel L. Ritz,Eoin Sherwin,Simon Spichak,Emily M. Teichman,Marcel van de Wouw,Ana Paula Ventura-Silva,Shauna E. Wallace-Fitzsimons,Niall P. Hyland,Gerard Clarke,Timothy G. Dinan +32 more
TL;DR: Future studies will focus on understanding the mechanisms underlying the microbiota-gut-brain axis and attempt to elucidate microbial-based intervention and therapeutic strategies for neuropsychiatric disorders.
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Immortalization of primary microglia: a new platform to study HIV regulation in the central nervous system
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References
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Journal ArticleDOI
Identification of a Reservoir for HIV-1 in Patients on Highly Active Antiretroviral Therapy
Diana Finzi,Monika Hermankova,Theodore C. Pierson,Lucy M. Carruth,Christopher B. Buck,Richard E. Chaisson,Thomas C. Quinn,Karen Chadwick,Joseph B. Margolick,Ron Brookmeyer,Joel E. Gallant,Martin Markowitz,David D. Ho,Douglas D. Richman,Robert F. Siliciano +14 more
TL;DR: In a study of 22 patients successfully treated with HAART for up to 30 months, replication-competent virus was routinely recovered from resting CD4+ T lymphocytes, and generally did not show mutations associated with resistance to the relevant antiretroviral drugs.
Journal ArticleDOI
Updated research nosology for HIV-associated neurocognitive disorders
Andrea Antinori,Gabriele Arendt,James T. Becker,Bruce J. Brew,Desiree Byrd,Mariana Cherner,David B. Clifford,Paola Cinque,Leon G. Epstein,K. Goodkin,Magnus Gisslén,Igor Grant,Robert K. Heaton,Jeymohan Joseph,Karen Marder,Camillo Marra,Justin C. McArthur,Michael Nunn,Richard W. Price,Lynn Pulliam,Kevin Robertson,Ned Sacktor,Victor Valcour,Valerie Wojna +23 more
TL;DR: This report reviews the collective experience with HIV-associated neurocognitive disorders (HAND), particularly since the advent of highly active antiretroviral treatment, and their definitional criteria; discusses the impact of comorbidities; and suggests inclusion of the term asymptomatic neuroc cognitive impairment to categorize individuals with subclinical impairment.
Journal ArticleDOI
HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER Study.
Robert K. Heaton,David B. Clifford,Donald Franklin,Steven Paul Woods,Christopher Ake,Florin Vaida,Ronald J. Ellis,S. Letendre,Thomas D. Marcotte,Joseph H. Atkinson,Monica Rivera-Mindt,Ofilio Vigil,Michael J. Taylor,Ann C. Collier,Camillo Marra,Benjamin B. Gelman,Justin C. McArthur,Susan Morgello,David M. Simpson,McCutchan Ja,Ian Abramson,Anthony Gamst,Christine Fennema-Notestine,Terry L. Jernigan,Joseph K. Wong,Igor Grant +25 more
TL;DR: The most severe HAND diagnosis (HAD) was rare, but milder forms of impairment remained common, even among those receiving CART who had minimal comorbidities.
Journal ArticleDOI
HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors
Robert K. Heaton,Donald Franklin,Ronald J. Ellis,J. Allen McCutchan,Scott Letendre,Shannon LeBlanc,Stephanie Corkran,Nichole A. Duarte,David B. Clifford,Steven Paul Woods,Ann C. Collier,Christina M. Marra,Susan Morgello,Monica Rivera Mindt,Michael J. Taylor,Thomas D. Marcotte,J. Hampton Atkinson,Tanya Wolfson,Benjamin B. Gelman,Justin C. McArthur,David M. Simpson,Ian Abramson,Anthony Gamst,Christine Fennema-Notestine,Terry L. Jernigan,Joseph K. Wong,Igor Grant +26 more
TL;DR: In this article, the authors used comparable methods of subject screening and assessments to classify neurocognitive impairment (NCI) in large groups of HIV + and HIV − participants from the pre-CART era (1988-1995, N = 857) and CART era(2000-2007; N = 937).
Journal ArticleDOI
The brain in AIDS: central nervous system HIV-1 infection and AIDS dementia complex
Richard W. Price,Bruce J. Brew,John J. Sidtis,Marc K. Rosenblum,Adrienne C. Scheck,Paul D. Cleary +5 more
TL;DR: Within the context of the permissive effect of immunosuppression, genetic changes in HIV-1 may underlie the neuropathological heterogeneity of the AIDS dementia complex and its relatively independent course in relation to the systemic manifestations of AIDS noted in some patients.
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