A Rationale and Approach to the Development of Specific Treatments for HIV Associated Neurocognitive Impairment
Neurocognitive impairment (NCI) associated with HIV infection of the brain impacts a large proportion of people with HIV (PWH) regardless of antiretroviral therapy (ART). While the number of PWH and severe NCI has dropped considerably with the introduction of ART, the sole use of ART is not sufficie...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/10/11/2244 |
| _version_ | 1797464474435715072 |
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| author | Aaron Scanlan Zhan Zhang Rajeth Koneru Monica Reece Christina Gavegnano Albert M. Anderson William Tyor |
| author_facet | Aaron Scanlan Zhan Zhang Rajeth Koneru Monica Reece Christina Gavegnano Albert M. Anderson William Tyor |
| author_sort | Aaron Scanlan |
| collection | DOAJ |
| description | Neurocognitive impairment (NCI) associated with HIV infection of the brain impacts a large proportion of people with HIV (PWH) regardless of antiretroviral therapy (ART). While the number of PWH and severe NCI has dropped considerably with the introduction of ART, the sole use of ART is not sufficient to prevent or arrest NCI in many PWH. As the HIV field continues to investigate cure strategies, adjunctive therapies are greatly needed. HIV imaging, cerebrospinal fluid, and pathological studies point to the presence of continual inflammation, and the presence of HIV RNA, DNA, and proteins in the brain despite ART. Clinical trials exploring potential adjunctive therapeutics for the treatment of HIV NCI over the last few decades have had limited success. Ideally, future research and development of novel compounds need to address both the HIV replication and neuroinflammation associated with HIV infection in the brain. Brain mononuclear phagocytes (MPs) are the primary instigators of inflammation and HIV protein expression; therefore, adjunctive treatments that act on MPs, such as immunomodulating agents, look promising. In this review, we will highlight recent developments of innovative therapies and discuss future approaches for HIV NCI treatment. |
| first_indexed | 2024-03-09T18:07:41Z |
| format | Article |
| id | doaj.art-281b5ac1441b43bd8a1e93c15b844cba |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-09T18:07:41Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-281b5ac1441b43bd8a1e93c15b844cba2023-11-24T09:17:08ZengMDPI AGMicroorganisms2076-26072022-11-011011224410.3390/microorganisms10112244A Rationale and Approach to the Development of Specific Treatments for HIV Associated Neurocognitive ImpairmentAaron Scanlan0Zhan Zhang1Rajeth Koneru2Monica Reece3Christina Gavegnano4Albert M. Anderson5William Tyor6Atlanta Veterans Affairs Medical Center, Decatur, GA 30033, USAAtlanta Veterans Affairs Medical Center, Decatur, GA 30033, USAAtlanta Veterans Affairs Medical Center, Decatur, GA 30033, USADepartment of Pathology, Division of Experimental Pathology, Emory University, Atlanta, GA 30322, USADepartment of Pathology, Division of Experimental Pathology, Emory University, Atlanta, GA 30322, USADepartment of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA 30322, USAAtlanta Veterans Affairs Medical Center, Decatur, GA 30033, USANeurocognitive impairment (NCI) associated with HIV infection of the brain impacts a large proportion of people with HIV (PWH) regardless of antiretroviral therapy (ART). While the number of PWH and severe NCI has dropped considerably with the introduction of ART, the sole use of ART is not sufficient to prevent or arrest NCI in many PWH. As the HIV field continues to investigate cure strategies, adjunctive therapies are greatly needed. HIV imaging, cerebrospinal fluid, and pathological studies point to the presence of continual inflammation, and the presence of HIV RNA, DNA, and proteins in the brain despite ART. Clinical trials exploring potential adjunctive therapeutics for the treatment of HIV NCI over the last few decades have had limited success. Ideally, future research and development of novel compounds need to address both the HIV replication and neuroinflammation associated with HIV infection in the brain. Brain mononuclear phagocytes (MPs) are the primary instigators of inflammation and HIV protein expression; therefore, adjunctive treatments that act on MPs, such as immunomodulating agents, look promising. In this review, we will highlight recent developments of innovative therapies and discuss future approaches for HIV NCI treatment.https://www.mdpi.com/2076-2607/10/11/2244HANDHIV neurocognitive impairmentneuroHIVHIVbrainadjunctive therapy |
| spellingShingle | Aaron Scanlan Zhan Zhang Rajeth Koneru Monica Reece Christina Gavegnano Albert M. Anderson William Tyor A Rationale and Approach to the Development of Specific Treatments for HIV Associated Neurocognitive Impairment Microorganisms HAND HIV neurocognitive impairment neuroHIV HIV brain adjunctive therapy |
| title | A Rationale and Approach to the Development of Specific Treatments for HIV Associated Neurocognitive Impairment |
| title_full | A Rationale and Approach to the Development of Specific Treatments for HIV Associated Neurocognitive Impairment |
| title_fullStr | A Rationale and Approach to the Development of Specific Treatments for HIV Associated Neurocognitive Impairment |
| title_full_unstemmed | A Rationale and Approach to the Development of Specific Treatments for HIV Associated Neurocognitive Impairment |
| title_short | A Rationale and Approach to the Development of Specific Treatments for HIV Associated Neurocognitive Impairment |
| title_sort | rationale and approach to the development of specific treatments for hiv associated neurocognitive impairment |
| topic | HAND HIV neurocognitive impairment neuroHIV HIV brain adjunctive therapy |
| url | https://www.mdpi.com/2076-2607/10/11/2244 |
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