Antineuroinflammatory drugs in HIV-associated neurocognitive disorders as potential therapy

Neurol Neuroimmunol Neuroinflamm. 2019 Apr 4;6(3):e551. doi: 10.1212/NXI.0000000000000551. eCollection 2019 May.

Abstract

Today, HIV-infected (HIV+) patients can be treated efficiently with combined antiretroviral therapy (cART), leading to long-term suppression of viral load, in turn increasing life expectancy. While cART reduced the occurrence of HIV-associated dementia, the prevalence of subtle forms of HIV-associated neurocognitive disorders (HAND) is unchanged. This is related to persistent immune activation within the CNS, which is not addressed by cART. Pathologic processes leading to HAND consist of the release of proinflammatory cytokines, chemokines, reactive oxygen metabolites and glutamate, and the release of HIV proteins. Some of those processes can be targeted using medications with immunomodulatory and neuroprotective properties such as dimethyl fumarate, teriflunomide, or minocycline. In this review, we will summarize the knowledge about key pathogenic processes involved in HAND and potential therapeutic avenues to target HAND.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • HIV Infections* / complications
  • HIV Infections* / immunology
  • Humans
  • Immunologic Factors / therapeutic use*
  • Neurocognitive Disorders* / drug therapy
  • Neurocognitive Disorders* / etiology
  • Neurocognitive Disorders* / immunology

Substances

  • Immunologic Factors