title: Proceedings from the NIMH symposium on "NeuroAIDS in Africa: neurological and neuropsychiatric complications of HIV".
abstract: Despite major advances in HIV-1 treatment, the prevalence of HIV-associated neurocognitive disorders (HAND) remains a problem, particularly as individuals on suppressive treatment continue to live longer. To facilitate discussion on emerging and future directions in HAND research, a meeting was held in Durban, South Africa in March 2015 as part of the Society of Neuroscientists of Africa (SONA) conference. The objective of the meeting was to assess the impact of HIV subtype diversity on HAND and immunological dysfunction. The meeting brought together international leaders in the area of neurological complications of HIV-1 infection with special focus on the African population. Research presentations indicated that HAND was highly prevalent and that inflammatory cytokines and immune-activation played important roles in progression of neurocognitive impairment. Furthermore, children on antiretroviral therapy were also at risk for developing neurocognitive impairment. With respect to the effect of HIV-1 subtype diversity, analyses of HIV-1 clade C infection among South Africans revealed that clade C infection induced cognitive impairment that was independent of the substitution in HIV-1 Trans-Activator of Transcription (Tat; C31S). At the cellular level, a Zambian study showed that clade C infection resulted in reduced brain cell death compared with clade B infection suggesting clade specific variations in mediating brain cell injury. Furthermore, ex vivo Tat protein from clade CRF02_AG, prevalent in West/ Central Africa, exhibited reduced disruption of brain endothelium compared with clade B Tat protein. Discussions shed light on future research directions aimed at understanding biomarkers and disease mechanisms critical for HAND.
authors.affiliation: University of Nebraska Medical Centre, Omaha, USA. sbuch@unmc.edu.
authors.forename: Shilpa
authors.initials: S
authors.lastname: Buch
authors.affiliation: University of Nebraska Medical Centre, Omaha, USA.
authors.forename: Ernest T
authors.initials: ET
authors.lastname: Chivero
authors.affiliation: University of Cape Town, Cape Town, South Africa.
authors.forename: Jackie
authors.initials: J
authors.lastname: Hoare
authors.affiliation: University of Maryland School of Medicine, Baltimore, USA.
authors.forename: Jibreel
authors.initials: J
authors.lastname: Jumare
authors.affiliation: Makerere University, Kampala, Uganda.
authors.forename: Noeline
authors.initials: N
authors.lastname: Nakasujja
authors.affiliation: University of Zambia, Lusaka, Zambia.
authors.forename: Victor
authors.initials: V
authors.lastname: Mudenda
authors.affiliation: University of Missouri-St. Louis, St. Louis, MO, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Paul
authors.affiliation: University of Nebraska Medical Centre, Omaha, USA.
authors.forename: Georgette D
authors.initials: GD
authors.lastname: Kanmogne
authors.affiliation: John Hopkins University, Baltimore, MD, USA.
authors.forename: Ned
authors.initials: N
authors.lastname: Sacktor
authors.affiliation: University of Nebraska-Lincoln, Lincoln, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Wood
authors.affiliation: University of Maryland School of Medicine, Baltimore, USA.
authors.forename: Walter
authors.initials: W
authors.lastname: Royal
authors.affiliation: Division of AIDS Research, National Institute of Mental Health, NIH, Bethesda, MD, USA. jjeymoha@mail.nih.gov.
authors.forename: Jeymohan
authors.initials: J
authors.lastname: Joseph
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000821:virology; D001921:Brain / Q000098:blood supply / Q000276:immunology / Q000473:pathology* / Q000821:virology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000473:pathology / Q000821:virology; D016207:Cytokines / Q000096:biosynthesis / Q000276:immunology*; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000276:immunology / Q000473:pathology / Q000821:virology; D005260:Female; D015497:HIV-1 / Q000145:classification / Q000472:pathogenicity* / Q000502:physiology; D054884:Host-Pathogen Interactions; D006801:Humans; D008297:Male; D058889:Molecular Typing; D009483:Neuropsychological Tests; D054322:tat Gene Products, Human Immunodeficiency Virus / Q000096:biosynthesis / Q000276:immunology
chemical_list: D016207:Cytokines; D054322:tat Gene Products, Human Immunodeficiency Virus
keywords: HIV-associated neurocognitive disorders (HAND); Human immunodeficiency virus (HIV); NeuroAIDS