scholarly journals Dual antiretroviral therapies are effective and safe regimens in the central nervous system of neurologically symptomatic people living with HIV

AIDS ◽  
2020 ◽  
Vol 34 (13) ◽  
pp. 1899-1906 ◽  
Author(s):  
Mattia Trunfio ◽  
Walter Rugge ◽  
Lorenzo Mighetto ◽  
Daniela Vai ◽  
Cristiana Atzori ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
People Living With Hiv ◽  
Antiretroviral Therapies ◽  
The Central Nervous System ◽  
Living With Hiv

A rare case of HIV CNS escape in a patient previously considered a viral controller

2020 ◽  
Vol 31 (7) ◽  
pp. 694-698
Author(s):  
Jessica Magid-Bernstein ◽  
Chu-Yueh Guo ◽  
Felicia C Chow ◽  
Kiran T Thakur
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Hiv Infection ◽  
Viral Suppression ◽  
Cns Infection ◽  
People Living With Hiv ◽  
Hiv Rna ◽  
Perinatal Hiv ◽  
The Central Nervous System ◽  
Living With Hiv

Human immunodeficiency virus (HIV) ribonucleic acid (RNA) levels generally remain undetectable in the cerebrospinal fluid of people living with HIV with peripheral viral suppression. Secondary HIV central nervous system (CNS) escape refers to the rare independent replication of HIV RNA in the central nervous system despite peripheral viral suppression that occurs in the setting of a concomitant non-HIV infection. We describe here a young man with perinatal HIV infection considered a viral controller who developed secondary HIV CNS escape in the setting of a presumed fungal CNS infection.

HIV-associated tuberculosis with central nervous system involvement (literature review)

MedAlliance ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 25-31
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Central Nervous System Involvement ◽  
High Viral Load ◽  
Future Research ◽  
People Living With Hiv ◽  
Associated Lesions ◽  
The Central Nervous System ◽  
Living With Hiv ◽  
Inflammatory Syndrome

Tuberculosis is one of the most common comorbidities in people living with HIV. Immunodeficiency caused by HIV contributes to the development of tuberculosis or aggra-vates the existing disease. At the same time, TB on the background of a pronounced immunodeficiency caused by HIV is more severe than in immunocompetent patients, since immunosuppression is a favorable background for the development of severe forms of tuberculosis. The most severe forms of tuberculosis in HIV infection include lesions of the central nervous system (CNS). This review is aimed to briefly summarize the studies of HIV-associated tuberculosis with CNS involvement, its clinical manifes-tations, complications, including those associated with the immune reconstitution inflammatory syndrome, dif-ferential diagnostics with other HIV-associated lesions of the central nervous system, methods of laboratory diag-nostics, and specifics of tuberculosis treatment in cases of high viral load. The study of possible influence of the genotype of the infecting Mycobacterium tuberculosis strains on the course and outcome of the disease is an important area for future research.

scholarly journals New Challenges of HIV-1 Infection: How HIV-1 Attacks and Resides in the Central Nervous System

Cells ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. 1245 ◽  
Author(s):  
Victoria Rojas-Celis ◽  
Fernando Valiente-Echeverría ◽  
Ricardo Soto-Rifo ◽  
Daniela Toro-Ascuy
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cell Types ◽  
Latent Reservoir ◽  
People Living With Hiv ◽  
Viral Load Suppression ◽  
The Central Nervous System ◽  
Immunodeficiency Syndrome ◽  
Living With Hiv ◽  
Hiv 1

Acquired immunodeficiency syndrome (AIDS) has become one of the most devastating pandemics in recorded history. The main causal agent of AIDS is the human immunodeficiency virus (HIV), which infects various cell types of the immune system that express the CD4 receptor on their surfaces. Today, combined antiretroviral therapy (cART) is the standard treatment for all people with HIV; although it has improved the quality of life of people living with HIV (PLWH), it cannot eliminate the latent reservoir of the virus. Therefore HIV/AIDS has turned from a fatal disease to a chronic disease requiring lifelong treatment. Despite significant viral load suppression, it has been observed that at least half of patients under cART present HIV-associated neurocognitive disorders (HAND), which have been related to HIV-1 infection and replication in the central nervous system (CNS). Several studies have focused on elucidating the mechanism by which HIV-1 can invade the CNS and how it can generate the effects seen in HAND. This review summarizes the research on HIV-1 and its interaction with the CNS with an emphasis on the generation of HAND, how the virus enters the CNS, the relationship between HIV-1 and cells of the CNS, and the effect of cART on these cells.

scholarly journals Crucial Role of Central Nervous System as a Viral Anatomical Compartment for HIV-1 Infection

2021 ◽  
Vol 9 (12) ◽  
pp. 2537
Author(s):  
Ana Borrajo ◽  
Valentina Svicher ◽  
Romina Salpini ◽  
Michele Pellegrino ◽  
Stefano Aquaro
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
People Living With Hiv ◽  
Viral Reservoirs ◽  
Virus Eradication ◽  
The Central Nervous System ◽  
Neurological Research ◽  
Living With Hiv ◽  
Hiv 1

The chronic infection established by the human immunodeficiency virus 1 (HIV-1) produces serious CD4+ T cell immunodeficiency despite the decrease in HIV-1 ribonucleic acid (RNA) levels and the raised life expectancy of people living with HIV-1 (PLWH) through treatment with combined antiretroviral therapies (cART). HIV-1 enters the central nervous system (CNS), where perivascular macrophages and microglia are infected. Serious neurodegenerative symptoms related to HIV-associated neurocognitive disorders (HAND) are produced by infection of the CNS. Despite advances in the treatment of this infection, HAND significantly contribute to morbidity and mortality globally. The pathogenesis and the role of inflammation in HAND are still incompletely understood. Principally, growing evidence shows that the CNS is an anatomical reservoir for viral infection and replication, and that its compartmentalization can trigger the evolution of neurological damage and thus make virus eradication more difficult. In this review, important concepts for understanding HAND and neuropathogenesis as well as the viral proteins involved in the CNS as an anatomical reservoir for HIV infection are discussed. In addition, an overview of the recent advancements towards therapeutic strategies for the treatment of HAND is presented. Further neurological research is needed to address neurodegenerative difficulties in people living with HIV, specifically regarding CNS viral reservoirs and their effects on eradication.

scholarly journals Improved Central Nervous System Symptoms in People with HIV without Objective Neuropsychiatric Complaints Switching from Efavirenz to Rilpivirine Containing cART

2019 ◽  
Vol 9 (8) ◽  
pp. 195 ◽  
Author(s):  
Vera ◽  
Bracchi ◽  
Alagaratnam ◽  
Lwanga ◽  
Fox ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Tenofovir Disoproxil Fumarate ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
People Living With Hiv ◽  
White Ethnicity ◽  
Patient Reported ◽  
Switching Therapy ◽  
Living With Hiv

Objective: Occult central nervous system (CNS) symptoms not recognized by people living with HIV (PLWH) receiving efavirenz or their clinicians could occur and impact people’s quality of life. The aim of this study was to determine whether CNS parameters improve in PLWH when switching from efavirenz to rilpivirine. Methods: PLWH receiving tenofovir disoproxil fumarate, emtricitabine, efavirenz (Atripla™) with undetectable HIV RNA, and no CNS symptoms were switched cART to tenofovir disoproxil fumarate, emtricitabine, rilpivirine (Eviplera™). CNS parameters including sleep, anxiety, and depressive symptoms were evaluated using patient-reported outcome measures at baseline, 4, 12, and 24 weeks after switching therapy. A median CNS score was derived from the sum of CNS toxicities of all the grades collected in the study questionnaires. Cognitive function was assessed using a computerized test battery. Results: Of 41 participants, median age was 47 years, Interquartile range (IQR) 31, 92% were male and 80% were of white ethnicity. A significant reduction in total CNS score (10 to 7) was observed at 4 weeks (p = 0.028), but not thereafter. Significant improvements in sleep and anxiety were observed 4, 12 and 24 weeks after switching therapy (p < 0.05). No significant change in global cognitive scores was observed. Conclusions: Switching from efavirenz to rilpivirine based regimens in virologically suppressed PLWH without perceived CNS symptoms was well tolerated and slightly improved overall CNS symptoms.

scholarly journals Neurological complications during HIV infection

2021 ◽  
Author(s):  
Jose Martinez-Navio
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Hiv Infection ◽  
Neurological Complications ◽  
Factors Influencing ◽  
Antiretroviral Therapies ◽  
Immunodeficiency Virus ◽  
The World ◽  
Infection Mechanisms ◽  
The Central Nervous System

Early in the course of infection, human immunodeficiency virus (HIV) is able to enter the central nervous system where it stablishes a permanent reservoir. Current antiretroviral therapies do not efficiently cross the blood-brain barrier and therefore do not reach the HIV located in the central nervous system. Consequently, HIV infection can often be associated with neurocognitive impairment and HIV-associated dementia. The purpose of this review is to brief the reader into the world of neurological complications arising from HIV infection. Mechanisms by which HIV directly or indirectly impairs the central nervous system are discussed, as well as other factors influencing or contributing to the impairment, and the animal models currently used to perform research on the topic.

Central Nervous System Opportunistic Infections in HIV-1 Infection

CNS Spectrums ◽  
2000 ◽  
Vol 5 (4) ◽  
pp. 43-60 ◽  
Author(s):  
Mauricio Concha ◽  
Alejandro Rabinstein
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Opportunistic Infections ◽  
Primary Cns Lymphoma ◽  
Cns Lymphoma ◽  
Antiretroviral Therapies ◽  
Immunodeficiency Virus ◽  
The Central Nervous System ◽  
Hiv 1

AbstractNeurologic disease is commonly encountered in the population infected with human immunodeficiency virus type 1 (HIV-1). Although HIV-1 is responsible for many of these neurologic complications, other organisms will affect the nervous system as the immune deficiency state progresses. With the wide use of potent antiretroviral therapy, the mortality from and incidence of opportunistic infections (OIs) among persons with advanced HIV-1 infection has decreased. Nevertheless, these diseases are still seen frequently, especially among those with limited access to new antiretroviral therapies. Therefore, it remains important to recognize the most common OIs of the central nervous system (CNS) as well as primary CNS lymphoma, which will be the focus of this review.

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