The neuropathogenesis of AIDS.
HIV-associated dementia (HAD) is an important complication of the central nervous system in patients who are infected with HIV-1. Although the incidence of HAD has markedly decreased since it has become possible to effectively control viral replication in the blood by administering highly active antiretroviral therapy, a less severe form of HAD, comprising a milder cognitive and motor disorder, is now potentially a serious problem. Brain macrophages and microglia are the key cell types that are infected by HIV-1 in the central nervous system, and they are likely to mediate the neurodegeneration seen in patients with HAD; however, the precise pathogenesis of this neurodegeneration is still unclear. Here, we discuss the studies that are being carried out to determine the respective contributions of infection, and monocyte and macrophage activation, to disease progression.
González-Scarano
Francisco
F
Department of Neurology, 3 West Gates, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, Philadelphia 19104-4283, USA. scarano@mail.med.upenn.edu
Martín-García
Julio
J
D015526:AIDS Dementia Complex / Q000209:etiology / Q000503:physiopathology / Q000821:virology*; D000163:Acquired Immunodeficiency Syndrome / Q000503:physiopathology*; D001921:Brain / Q000378:metabolism / Q000821:virology*; D018925:Chemokines / Q000378:metabolism; D018450:Disease Progression; D015497:HIV-1; D006801:Humans; D008262:Macrophage Activation; D008264:Macrophages / Q000821:virology; D017628:Microglia / Q000821:virology; D019636:Neurodegenerative Diseases / Q000378:metabolism / Q000821:virology; D019707:Receptors, Chemokine / Q000378:metabolism
D018925:Chemokines; D019707:Receptors, Chemokine