Neurologic complications of HIV disease and their treatments.
The 2006 Conference on Retroviruses and Opportunistic Infections was marked by a record number of presentations focused on the neurologic complications of HIV infection. Key findings included the identification of the high prevalence of HIV-associated neurocognitive impairment (HNCI) in Western and East Asian populations; biomarkers that may be clinically useful in determining risk and treatment of HNCI, such as neurofilament protein, insulin resistance, leptin, soluble Fas, and total protein levels in cerebrospinal fluid; host genotypes that were associated with HNCI as well as antiretroviral toxic neuropathy; HIV envelope signature positions that were associated with HNCI and reduced CD4 dependence; the importance of combined antiretroviral drug penetration into the central nervous system for control of HIV replication; and an effective treatment for painful sensory neuropathy (capsaicin) and provocative preclinical data on treatments for HIV-associated neurocognitive impairment (rosiglitazone, glatiramer immunization). Together, these findings heighten concern for persistent neurologic diseases in antiretroviral therapy-treated individuals but provide guidance for their improved identification and treatment.
Letendre
Scott
S
Department of Medicine, University of California San Diego, CA, USA.
Ellis
Ronald J
RJ
D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D009422:Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D012307:Risk Factors
D019380:Anti-HIV Agents; D015415:Biomarkers