HIV-1 associated dementia: symptoms and causes.
Despite the use of highly active antiretroviral therapy (HAART), neuronal cell death remains a problem that is frequently found in the brains of HIV-1-infected patients. HAART has successfully prevented many of the former end-stage complications of AIDS, however, with increased survival times, the prevalence of minor HIV-1 associated cognitive impairment appears to be rising among AIDS patients. Further, HIV-1 associated dementia (HAD) is still prevalent in treated patients as well as attenuated forms of HAD and CNS opportunistic disorders. HIV-associated cognitive impairment correlates with the increased presence in the CNS of activated, though not necessarily HIV-1-infected, microglia and CNS macrophages. This suggests that indirect mechanisms of neuronal injury and loss/death occur in HIV/AIDS as a basis for dementia since neurons are not themselves productively infected by HIV-1. In this review, we discussed the symptoms and causes leading to HAD. Outcome from this review will provide new information regarding mechanisms of neuronal loss in AIDS patients.
Ghafouri
Mohammad
M
Department of Neuroscience, Center for Neurovirology, Temple University School of Medicine, Pennsylvania 19122, USA. ghafouri@temple.edu
Amini
Shohreh
S
Khalili
Kamel
K
Sawaya
Bassel E
BE
D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000473:pathology; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D023241:Antiretroviral Therapy, Highly Active; D001921:Brain / Q000473:pathology / Q000821:virology; D015658:HIV Infections / Q000188:drug therapy; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D009474:Neurons / Q000473:pathology / Q000821:virology; D015995:Prevalence