scholarly journals Antiretroviral Therapy and HIV-Associated Neurocognitive Disorders

10.5772/23080 ◽  
2011 ◽  
Author(s):  
Cagla Akay ◽  
Kelly L.
Keyword(s):  
Antiretroviral Therapy ◽  
Neurocognitive Disorders ◽  
Hiv Associated Neurocognitive Disorders

scholarly journals Prevalence and Correlates of HIV-Associated Neurocognitive Disorders (HAND) in Northwestern Nigeria

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Ahmad M. Yakasai ◽  
Mustafa I. Gudaji ◽  
Hamza Muhammad ◽  
Aliyu Ibrahim ◽  
Lukman F. Owolabi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Neuropsychological Test ◽  
Binary Logistic Regression ◽  
Neurocognitive Disorders ◽  
Hiv Positive ◽  
Binary Logistic Regression Model ◽  
Highly Active ◽  
Patients At Risk ◽  
Hiv Associated Neurocognitive Disorders

HIV-associated Neurocognitive Disorders (HAND) are common among HIV-positive individuals. This study explored the prevalence and correlates of HAND in Nigeria. 80 HIV-positive and 40 HIV-negative adults selected from Aminu Kano Teaching Hospital (AKTH) received comprehensive evaluations. A multidomain neuropsychological test (MDNPT) battery assessing 7 domains was administered to the participants and their performance was combined with measures of functional status to classify impairments into various grades of HAND. Univariate and multivariate analyses were performed to identify correlates of symptomatic HAND. Among the HIV-positive individuals, 50% were highly active antiretroviral therapy-experienced (HAART+) and 50% were highly active antiretroviral therapy naive (HAART−). Symptomatic HAND was found among 40% of the HAART− individuals and 30% of the HAART+ individuals. Respective prevalence of HIV-associated dementia (HAD) was 23% and 5%, respectively (p=0.0002). In a binary logistic regression model, only fewer years of education independently predicted symptomatic HAND [Odds Ratio (OR) = 1.2, 95% confidence interval (CI) = 1.04–1.44,p=0.016]. The prevalence of HAND in Nigeria is high with HAD being commoner among HAART− patients. Provision of HAART and strict monitoring of patients at risk of HAND are needed to scale down the burden of the disease.

scholarly journals HIV Nef and Antiretroviral Therapy Have an Inhibitory Effect on Autophagy in Human Astrocytes that May Contribute to HIV-Associated Neurocognitive Disorders

Cells ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 1426
Author(s):  
Laura Cheney ◽  
Hillary Guzik ◽  
Frank P. Macaluso ◽  
Fernando Macian ◽  
Ana Maria Cuervo ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Inhibitory Effect ◽  
Neurocognitive Disorders ◽  
Autophagic Flux ◽  
People Living With Hiv ◽  
Autophagosome Formation ◽  
Human Astrocytes ◽  
Transmission Electron ◽  
Living With Hiv ◽  
Hiv Associated Neurocognitive Disorders

A significant number of people living with HIV (PLWH) develop HIV-associated neurocognitive disorders (HAND) despite highly effective antiretroviral therapy (ART). Dysregulated macroautophagy (autophagy) is implicated in HAND pathogenesis. The viral protein Nef, expressed even with suppressive ART, and certain antiretrovirals affect autophagy in non-CNS cells. Astrocytes, vital for CNS microenvironment homeostasis and neuronal health, require autophagy for their own homeostasis. We hypothesized that extracellular Nef and/or ART impact astrocyte autophagy, thus contributing to HAND. We studied in-bulk and selective autophagic flux in primary human astrocytes treated with extracellular Nef and/or a combination of tenofovir+emtricitabine+raltegravir (ART) using Western blotting, a tandem fluorescent LC3 reporter, and transmission electron microscopy/morphometry. We show that after 24 h treatment, Nef and ART decrease autophagosomes through different mechanisms. While Nef accelerates autophagosome degradation without inducing autophagosome formation, ART inhibits autophagosome formation. Combination Nef+ART further depletes autophagosomes by inducing both abnormalities. Additionally, extracellular Nef and/or ART inhibit lysosomal degradation of p62, indicating Nef and/or ART affect in-bulk and selective autophagy differently. Dysregulation of both autophagic processes is maintained after 7 days of Nef and/or ART treatment. Persistent autophagy dysregulation due to chronic Nef and/or ART exposure may ultimately result in astrocyte and neuronal dysfunction, contributing to HAND.

scholarly journals HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER Study

Neurology ◽  
2010 ◽  
Vol 75 (23) ◽  
pp. 2087-2096 ◽  
Author(s):  
R. K. Heaton ◽  
D. B. Clifford ◽  
D. R. Franklin ◽  
S. P. Woods ◽  
C. Ake ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Neurocognitive Disorders ◽  
Hiv Associated Neurocognitive Disorders

HIV-Associated Neurocognitive Disorders

2017 ◽  
Author(s):  
Joshua Alexander ◽  
David J Croteau ◽  
Ronald J Ellis
Keyword(s):  
Cognitive Impairment ◽  
Antiretroviral Therapy ◽  
Neurocognitive Disorders ◽  
Virologic Suppression ◽  
Neurocognitive Disorder ◽  
Asymptomatic Neurocognitive Impairment ◽  
Antiretroviral Adherence ◽  
Combined Antiretroviral Therapy ◽  
Neurocognitive Decline ◽  
Hiv Associated Neurocognitive Disorders

Three subclassifications of HIV Associated Neurocognitive Disorders (HAND) can be delineated: asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND), and HIV-associated dementia (HAD). HAND occurs in about half of patients infected with HIV. All forms, including ANI and MND, are associated with unemployment and reduced antiretroviral adherence, which can lead to loss of virologic suppression, further neurocognitive decline, and systemic illness. Fortunately, combined antiretroviral therapy can stabilize and even reverse cognitive impairment.

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