Aging with HIV-1 Infection: Motor Functions, Cognition, and Attention – A Comparison with Parkinson’s Disease

Abstract

Recent advances in highly active anti-retroviral therapy (HAART) in their various combinations have dramatically increased the life expectancies of HIV-infected persons. People diagnosed with HIV are living beyond the age of 50 but are experiencing the cumulative effects of HIV infection and aging on brain function. In HIV-infected aging individuals, the potential synergy between immunosenescence and HIV viral loads increases susceptibility to HIV-related brain injury and functional brain network degradation similar to that seen in Parkinson’s disease (PD), the second most common neurodegenerative disorder in the aging population. Although there are clear diagnostic differences in the primary pathology of both diseases, i.e., death of dopamine-generating cells in the substantia nigra in PD and neuroinflammation in HIV, neurotoxicity to dopaminergic terminals in the basal ganglia (BG) has been implied in the pathogenesis of HIV and neuroinflammation in the pathogenesis of PD. Similar to PD, HIV infection affects structures of the BG, which are part of interconnected circuits including mesocorticolimbic pathways linking brainstem nuclei to BG and cortices subserving attention, cognitive control, and motor functions. The present review discusses the combined effects of aging and neuroinflammation in HIV individuals on cognition and motor function in comparison with age-related neurodegenerative processes in PD. Despite the many challenges, some HIV patients manage to age successfully, most likely by redistribution of neural network resources to enhance function, as occurs in healthy elderly; such compensation could be curtailed by emerging PD.

Neuronal Stress and Injury Caused by HIV-1, cART and Drug Abuse: Converging Contributions to HAND

“…Other combination and/or regimen are selected based primarily on antiviral efficacy, potential adverse effects (toxicity), pill burden, drug-drug interaction, comorbid conditions and cost (see [124] on 12/1/2016). As a result of effective cART, HIV-1 infection has become a chronic condition and infected individuals have a longer, near normal life span leading to aging with HIV as a new clinical phenomenon [51,127,128,129]. …”

An Overview of Human Immunodeficiency Virus Type 1-Associated Common Neurological Complications: Does Aging Pose a Challenge?

“…A large subset of HIV-infected patients present akinetic Parkinsonian syndromes at the early stage of disease onset, but PD-like syndromes are mostly reversed by HAART depending on the age and genetic predisposition of the patient [227, 228]. Patients who survive beyond 50 years of age most often exhibit accelerated degradation of neural networks compared with age-matched controls, mostly in the basal ganglia and hippocampal regions, due to the synergistic effects of immune-senescence and sustained viral load, despite beingundercontrol[229]. Multiplestudies,inpatients and animal models, show that dopaminergic neurons are the most vulnerable to HIV-infection.…”

“…Multiplestudies,inpatients and animal models, show that dopaminergic neurons are the most vulnerable to HIV-infection. Interestingly, increased levels of α-synuclein are found in the substantia nigra of HIV-infected patients compared with that of normal age-matched controls[229],which is one major cause of the depletion of dopaminergic neurons in α-synuclein gene triplication-associated PD. In a separate study, Riederer and colleagues showed in a primate model that HIV infection can decrease dopamine levels by at least 44% within only 2 months of infection, which is consistent with observations of HIV-infected patients [230].…”

Función motora en adultos que viven con VIH

“…Las comorbilidades más frecuentes en esta población son las infecciosas y le siguen las cardiovasculares, metabólicas, neoplasias, osteoporosis y enfermedades neurológicas degenerativas (4,5).…”