HIV and the brain.

Area of Science:

• Neuroscience
• Infectious Diseases
• Public Health

Background:

• HIV affects the brain, historically leading to opportunistic infections and dementia.
• Effective combination antiretroviral therapy (ART) dramatically reduced severe HIV-related neurological conditions.
• Milder neurocognitive impairment in people with HIV remains a significant concern.

Purpose of the Study:

• To summarize the historical and current impact of HIV on the brain.
• To discuss the role of ART in altering the landscape of HIV-related neurological conditions.
• To highlight the ongoing challenge of neurocognitive impairment in the aging HIV-positive population.

Main Methods:

• Literature review of studies on HIV and neurological complications.
• Analysis of trends in HIV-related dementia and opportunistic brain infections before and after ART.
• Examination of current research on persistent neurocognitive impairment in individuals with HIV.

Main Results:

• Before ART, opportunistic infections and HIV-related dementia were common in people with AIDS.
• Combination ART led to a significant decline in the prevalence of these severe neurological conditions.
• Less severe neurocognitive impairment remains prevalent and may be increasing as people with HIV live longer.

Conclusions:

• While ART has transformed outcomes, HIV neurological complications, particularly milder neurocognitive impairment, persist.
• The long-term effects of living with HIV necessitate continued research into brain health.
• Understanding and managing ongoing neurocognitive issues are crucial for the well-being of people with HIV.