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Huntington Disease l: Introduction

Huntington disease or HD is a progressive, fatal neurodegenerative disorder inherited in an autosomal dominant pattern.PathophysiologyIt is caused by expansion of the CAG trinucleotide repeat in the HTT gene on chromosome 4 (4p16.3), producing an abnormal huntingtin protein with an expanded polyglutamine tract. This misfolded protein disrupts cellular function, leading to neuronal death. Normal alleles have ≤26 repeats, 27–35 are intermediate (risk of expansion), 36–39 show reduced penetrance,...
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Quantification of Cerebral Vascular Architecture using Two-photon Microscopy in a Mouse Model of HIV-induced Neuroinflammation
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[HIV-Associated Neurocognitive Disorders (HAND)].

Hiroaki Yokote1, Taiichiro Kobayashi, Yoshiharu Miura

  • 1Department of Neurology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital.

Brain and Nerve = Shinkei Kenkyu No Shinpo
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PubMed
Summary

HIV-associated neurocognitive disorders (HAND) affect 20-50% of people with HIV. New strategies are needed to address the central nervous system (CNS) reservoir for effective HAND treatment.

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Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Neurology

Background:

  • HIV-associated neurocognitive disorders (HAND) present insidiously and progressively in 20-50% of individuals with HIV.
  • Diagnosis of HAND lacks specific biomarkers, relying on comprehensive neuropsychological assessment.
  • HIV establishes a central nervous system (CNS) reservoir early in infection, persisting despite antiretroviral therapy.

Purpose of the Study:

  • To highlight the diagnostic challenges in HAND.
  • To emphasize the significance of the CNS HIV reservoir.
  • To advocate for novel therapeutic strategies targeting the CNS reservoir.

Main Methods:

  • Review of current diagnostic criteria for HAND.
  • Analysis of the impact of antiretroviral therapy on CNS HIV.
  • Discussion of the implications of the CNS reservoir for treatment.

Main Results:

  • HAND diagnosis remains challenging due to the absence of specific laboratory or neuroimaging markers.
  • Antiretroviral therapy, while beneficial, does not fully eradicate the CNS HIV reservoir.
  • The persistent CNS reservoir poses a significant barrier to complete HAND management.

Conclusions:

  • Comprehensive neuropsychological assessment is the current gold standard for HAND diagnosis.
  • Therapeutic strategies must evolve to specifically target the CNS HIV reservoir.
  • Future research should focus on developing treatments that can effectively clear the CNS reservoir to improve HAND outcomes.