Opioid and neuroHIV Comorbidity - Current and Future Perspectives

Area of Science:

• Neuroscience
• Infectious Diseases
• Pharmacology

Background:

• The national opioid crisis necessitates understanding opioid-HIV interactions in the CNS.
• While progress has been made, the specific impact of opioids on neuroHIV and HAND remains unclear.

Purpose of the Study:

• To review current knowledge on the molecular, cellular, and systems-level mechanisms of opioid-HIV interactions.
• To explore whether combined opioid-HIV pathogenesis causes unique deficits.

Main Methods:

• Review of preclinical and clinical studies.
• Emphasis on HIV-1 gene products and their interactions with host factors.
• Consideration of μ-opioid receptor (MOR) and chemokine co-receptor interactions.

Main Results:

• Opioid and HIV co-exposure can compromise the blood-brain barrier.
• Opioid exposure influences drug efflux transporters, affecting brain drug penetration.
• Combined effects of HIV variants, host factors, and receptor interactions are crucial.

Conclusions:

• Further research is needed to elucidate the unique contributions of opioids to neuroHIV pathophysiology.
• Understanding these interactions is critical for managing neurocognitive comorbidities in co-infected individuals.