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Untangling the Gordian knot of HIV, stress, and cognitive impairment

Arielle N Valdez1, Leah H Rubin2, Gretchen N Neigh3

  • 1Emory University Medical Scientist Training Program, USA; Emory University Department of Cell Biology, USA.

Neurobiology of Stress
|December 17, 2016
PubMed

Insights

The aging HIV epidemic presents challenges like inflammation-related diseases. Understanding the interplay of HIV, stress, and inflammation is key to addressing cognitive decline in aging individuals.

Area of Science:

  • Gerontology
  • Immunology
  • Neuroscience

Background:

  • The "graying of the HIV epidemic" highlights increased age-related comorbidities in people living with HIV (PLWH).
  • Complex diseases like cardiovascular disease, type II diabetes, cancer, and dementia are prevalent but their biological underpinnings in PLWH are not fully understood.
  • Inflammation is increasingly recognized as a critical factor in aging and chronic disease.

Approach:

  • This review examines the intricate interactions between HIV, stress, and cognitive impairment.
  • It specifically investigates the role of inflammation as a central mediator in these complex dynamics.
  • The review considers the implications for future research and clinical interventions.

Key Points:

  • HIV, chronic stress, and inflammation are interconnected and significantly impact cognitive function.
  • Inflammation appears to be a critical link, potentially driving age-related diseases in PLWH.
  • Aberrant cycles of these factors can become established, necessitating multifaceted interventions over time.
  • Early intervention may be effective, but established cycles may require broader therapeutic approaches.

Conclusions:

  • A comprehensive understanding of the interplay between HIV, inflammation, and stress is crucial for addressing cognitive impairment in aging populations.
  • Recognizing these interactions is a vital step towards personalized medicine for PLWH.
  • Future research should consider simultaneous multi-dimensional approaches or identify critical intervention points to break the cycle of disease progression.

Keywords:
ACTH, Adrenocorticotropic hormoneAIDS, Acquired immune deficiency syndromeANI, Asymptomatic neurocognitive impairmentART, Antiretroviral therapyCBSM, Cognitive behavioral stress managementCD4CNS, Central Nervous SystemCRP, C-reactive proteinCognitionGALT, Gut-associated lymphoid tissueGR, Glucocorticoid receptorHAD, HIV-associated dementiaHANA, HIV-associated, Non-AIDSHAND, HIV-associated neurocognitive disordersHIVHPA, Hypothalamic–Pituitary AdrenalHRV, Heart rate variabilityIL-12, Interleukin-12IL-18, Interleukin-18IL-1β, Interleukin-1βIL-2, Interleukin-2IL-6, Interleukin-6INSTIs, Integrase strand transfer inhibitorsInflammationLPS, LipopolysaccharideLTP, Long-term potentiationMND, Mild neurocognitive disorderNNRTIs, Non-nucleoside reverse transcriptase inhibitorsNRTIs, Nucleoside reverse transcriptase inhibitorsPFC, Prefrontal cortexPIs, Protease inhibitorsPLWH, People living with HIVPTSD, Posttraumatic stress disorderROS, Reactive oxygen speciesStressTNFα, Tumor necrosis factor alphaVpr, Viral protein rWIHS, Women's Interagency HIV StudyhsCRP, High-sensitivity C-reactive protein

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