scholarly journals Clinical Treatment Options and Randomized Clinical Trials for Neurocognitive Complications of HIV Infection: Combination Antiretroviral Therapy, Central Nervous System Penetration Effectiveness, and Adjuvants

2020 ◽  
Author(s):  
Shih-Ping Lin ◽  
Andrea Calcagno ◽  
Scott L. Letendre ◽  
Qing Ma
Keyword(s):  
Central Nervous System ◽  
Clinical Trials ◽  
Nervous System ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Randomized Clinical Trials ◽  
Treatment Options ◽  
Clinical Treatment ◽  
Combination Antiretroviral Therapy ◽  
Central Nervous System Penetration

scholarly journals Human Immunodeficiency Virus Type-1 (HIV-1) Transcriptional Regulation, Latency and Therapy in the Central Nervous System

Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1272
Author(s):  
Joseph Hokello ◽  
Adhikarimayum Lakhikumar Sharma ◽  
Priya Tyagi ◽  
Alok Bhushan ◽  
Mudit Tyagi
Keyword(s):  
Central Nervous System ◽  
Human Immunodeficiency Virus ◽  
Nervous System ◽  
Transcriptional Regulation ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Combination Antiretroviral Therapy ◽  
Hiv Replication ◽  
Immunodeficiency Virus ◽  
The Central Nervous System

The central nervous system (CNS) is highly compartmentalized and serves as a specific site of human immunodeficiency virus (HIV) infection. Therefore, an understanding of the cellular populations that are infected by HIV or that harbor latent HIV proviruses is imperative in the attempts to address cure strategies, taking into account that HIV infection and latency in the CNS may differ considerably from those in the periphery. HIV replication in the CNS is reported to persist despite prolonged combination antiretroviral therapy due to the inability of the current antiretroviral drugs to penetrate and cross the blood–brain barrier. Consequently, as a result of sustained HIV replication in the CNS even in the face of combination antiretroviral therapy, there is a high incidence of HIV-associated neurocognitive disorders (HAND). This article, therefore, provides a comprehensive review of HIV transcriptional regulation, latency, and therapy in the CNS.

Central Nervous System HIV Infection in “Less-Drug Regimen” Antiretroviral Therapy Simplification Strategies

2014 ◽  
Vol 34 (01) ◽  
pp. 078-088 ◽  
Author(s):  
Nicola Gianotti ◽  
Adriano Lazzarin ◽  
Paola Cinque ◽  
Francesca Ferretti
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Drug Regimen

scholarly journals CNS Infections Caused by Brown-Black Fungi

2019 ◽  
Vol 5 (3) ◽  
pp. 60 ◽  
Author(s):  
Jon Velasco ◽  
Sanjay Revankar
Keyword(s):  
Central Nervous System ◽  
Clinical Trials ◽  
Nervous System ◽  
Small Proportion ◽  
Randomized Clinical Trials ◽  
Immunocompromised Patients ◽  
Dematiaceous Fungi ◽  
Standard Drug ◽  
Cns Infections ◽  
Black Fungi

Central nervous system (CNS) infections caused by brown-black or dematiaceous fungi are distinctly rare and represent a small proportion of infections termed phaeohyphomycoses. However, these are becoming more commonly reported. Though many fungi have been implicated in disease, most cases are caused by only a few species, Cladophialophora bantiana being the most common. Most of the fungi described are molds, and often cause infection in immunocompetent individuals, in contrast to infection with other more common molds such as Aspergillus, which is usually seen in highly immunocompromised patients. Diagnosis is challenging, as there are no specific tests for this group of fungi. In addition, these infections are often refractory to standard drug therapies, requiring an aggressive combined surgical and medical approach to improve outcomes, yet mortality remains high. There are no standardized treatments due to a lack of randomized clinical trials, though guidelines have been published based on available data and expert opinion.

scholarly journals Immune Reсоnstitution Inflammatory Syndrome neuroradiologic features in HIV Infection

2020 ◽  
Vol 11 (1) ◽  
pp. 38-45
Author(s):  
E. G. Bakulina ◽  
T. N. Trofimova ◽  
A. S. Shelomov ◽  
G. V. Kataeva ◽  
N. A. Belyakov
Keyword(s):  
Central Nervous System ◽  
Human Immunodeficiency Virus ◽  
Nervous System ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Clinical Status ◽  
Diagnostic Algorithm ◽  
Immunodeficiency Virus ◽  
Paradoxical Worsening ◽  
Inflammatory Syndrome

The introduction of antiretroviral therapy has changed the human immunodeficiency virus pandemic. Some patients with HIV infection after starting or resuming ART develop a paradoxical worsening of clinical status, called Immune Reсоnstitution Inflammatory Syndrome (IRIS). However, if clinical and laboratory criteria for the diagnosis of this syndrome have been formulated, IRIS neuroradiological criteria do not exist yet. The present study presents neuroradiological features and diagnostic algorithm for identification of IRIS involving central nervous system.

Neurosurgery and human immunodeficiency virus in the era of combination antiretroviral therapy: a review

2017 ◽  
Vol 126 (3) ◽  
pp. 897-907 ◽  
Author(s):  
Duncan Henderson ◽  
Hugh P. Sims-Williams ◽  
Thomas Wilhelm ◽  
Helen Sims-Williams ◽  
Sanjay Bhagani ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Human Immunodeficiency Virus ◽  
Nervous System ◽  
Antiretroviral Therapy ◽  
Opportunistic Infections ◽  
Brain Lesions ◽  
Hiv Positive ◽  
Combination Antiretroviral Therapy ◽  
Immunodeficiency Virus ◽  
The Central Nervous System

Human immunodeficiency virus (HIV) is a global health problem. It renders the central nervous system susceptible to infectious and noninfectious diseases. HIV-positive individuals may present to neurosurgical services with brain lesions of unknown etiology. The differential diagnosis in these cases is broad, including opportunistic infections and malignancies, and investigation should be tailored accordingly. Opportunistic infections of the central nervous system can be complicated by hydrocephalus, and the management is pathogen dependent. Patients may also present to a neurosurgical service with conditions unrelated to their HIV status. This review outlines important conditions that cause brain lesions and hydrocephalus. It addresses the issues of diagnosis and intervention in HIV-positive patients in the era of combination antiretroviral therapy, while not ignoring the potential for opportunistic central nervous system infection in undiagnosed patients. The care of HIV-positive patients presenting to neurosurgical services requires a multidisciplinary approach, which is reflected in the authorship of this review, as well as in the guidance given.

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