HIV and aging: effects on the central nervous system.

Area of Science:

• Gerontology and Infectious Diseases
• Neuroscience and Neurology

Background:

• Combination antiretroviral therapy (ART) enables human immunodeficiency virus-positive (HIV+) individuals to live longer, increasing the aging HIV+ population.
• Both HIV infection and the aging process independently contribute to neuropathological changes in the central nervous system (CNS).
• The concurrence of HIV and aging may lead to more severe CNS damage than either factor alone.

Purpose of the Study:

• To review published data on neurocognitive and neuroimaging markers in aging HIV+ individuals.
• To describe factors contributing to neurocognitive impairment and neuroimaging changes in the aging HIV+ brain.
• To explore the potential relationship between HIV and Alzheimer's disease markers.

Main Methods:

• Review of published scientific literature on neurocognitive and neuroimaging findings in aging HIV+ populations.
• Analysis of factors implicated in CNS compromise, including metabolic disturbances, cardiovascular risks, immune senescence, and neuroinflammation.
• Examination of research on the association between HIV and Alzheimer's disease biomarkers.

Main Results:

• The aging HIV+ brain exhibits neuropathological changes influenced by both HIV and aging.
• Factors such as metabolic issues, cardiovascular risks, immune senescence, and neuroinflammation contribute to neurocognitive and neuroimaging alterations.
• Evidence suggests a possible link between HIV and certain markers associated with Alzheimer's disease.

Conclusions:

• Multiple mechanisms involving HIV and ART contribute to the decline of CNS structure and function in aging individuals.
• Understanding these interactions is crucial for managing the long-term neurological health of the growing aging HIV+ population.
• Further research is needed to elucidate the precise relationship between HIV, aging, and neurodegenerative diseases like Alzheimer's.