The impact of HIV central nervous system persistence on pathogenesis

Brew, Bruce J.; Barnes, Stephanie L.

doi:10.1097/qad.0000000000002251

Cited by 26 publications

(35 citation statements)

References 126 publications

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“…Because the aging and low immunity of ILWH are more common, they are more susceptible to the above six factors and suffer from these NAD than ordinary HIV infected people. Many papers have demonstrated these reasons [17,19,[53][54][55][56][57][58][59][60][61]. Studies have shown that NADM is the main cause of death among HIV-infected persons with NAD [7,17,22,35], so early screening of HIV-inpatients is needed.…”

Section: Discussionmentioning

confidence: 99%

Future Challenges for Changes in the Disease Burden of Inpatients Living With HIV in China: a Predictive Study

Shuai

Nie

Huang

et al. 2021

Preprint

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Objective: In China, the widespread use of Combination Antiretroviral Therapy(cART) has significantly improved the prognosis and quality of life in people living with HIV(PLWH). However, some PLWH still got worse and were hospitalized for some reasons, including AIDS-Defining Diseases(AD, such as opportunistic infections and AIDS-related Malignancies), Non-AIDS-Defining Diseases (NAD, such as non-AIDS-defining Malignancies and metabolic syndrome). At present, the age and disease of inpatients living with HIV(ILWH) are undergoing some significant changes. For example, the average age of ILWH is gradually increasing, the proportions of ILWH with NAD in all age groups are increasing, and the proportion of ILWH suffering from multiple types of NAD is increasing, which will have a greater impact to both ILWH and infectious disease hospitals. We aim to predict the changes in ILWH in the next 10 years, analyze the impact of such changes on ILWH and infectious disease hospitals in China, and propose corresponding countermeasures. Methods: We have established a prediction model based on Artificial Neural Network and Time series, using 12618 data of ILWH admitted to Chongqing Public Health Medical Center during 2010-2020, to predict the age of ILWH, the proportion of AD and NAD, the proportion of multiple types of NAD, and the proportion of NAD occurrences among various age groups from 2021 to 2030.Results: Our model shows that the average age of ILWH has risen from 43.8 years in 2010 to 57.6 years in 2030, and the increase in the age of women is greater than that of men. The number of ILWH in different age groups has changed significantly. Among them, the proportion of ILWH under 50 years old has gradually decreased, and the proportion of ILWH over 50 years old has gradually raised. By 2030, the proportion of inpatients over 50 years old will be close to 80%. The proportion of fatal opportunistic infections among ILWH has decreased year by year, and the most common diseases are tuberculosis-related diseases. The proportions of ILWH with only AD or NAD have gradually decreased, and the proportion of ILWH with both AD and NAD has increased year by year. It is estimated that the proportion of all ILWH with both AD and NAD will exceed 80% by 2030. Among all kinds of diseases in NAD, metabolic syndrome will have the highest rate of increase. By 2030, it will account for 16% in all ILWH. The proportion of hepatobiliary and pancreatic system diseases and blood system diseases in NAD will gradually decrease, while the proportion of metabolic syndrome, kidney disease, gastrointestinal disease, non-AIDS defining malignancies(NADM), bone disease and neurological diseases in NAD will gradually increase. The proportion of ILWH with NAD in all age groups will increase significantly after 10 years. Among them, the proportion of ILWH with NAD in 50-60 years old will be more than 80%, and among the ILWH under 30 years old, the proportion of ILWH suffering from NAD will increase to 69.6%. The proportion of ILWH without NAD or only 1 NAD will decrease, while the proportion of ILWH with 3 or more NAD will rise sharply. The proportion of ILWH with 1 type of NAD will drop to 12.6%, while the proportion of ILWH with 2 types of NAD, and the proportion of ILWH with 3 or more types of NAD will increase greatly. Conclusions: Significant changes have took place in the disease burden of ILWH in China, including the aging, the increase in the proportion of ILWH with NAD, and the increase in the proportion of ILWH with multiple types of NAD. These changes mean that in the next 10 years, the diagnosis, treatment and care of ILWH, as well as the development and construction of infectious disease hospitals will all face new challenges. This finding is based on a large number of long-term ILWH data in Chongqing, China, so we can consider that our research strategy can be promoted in China to improve the cure rate and quality of life in ILWH.

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Section: Discussionmentioning

confidence: 99%

Future Challenges for Changes in the Disease Burden of Inpatients Living With HIV in China: a Predictive Study

Shuai

Nie

Huang

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Because the aging and low immunity of ILWH are more common, they are more susceptible to the above six factors and suffer from these NAD than ordinary HIV infected people. Many papers have demonstrated these reasons [17,19,[54][55][56][57][58][59][60][61][62]. Studies have shown that NADM is the main cause of death among HIV-infected persons with NAD [7,17,22,35], so early screening of HIV-inpatients is needed.…”

Section: Discussionmentioning

confidence: 99%

Changes And Future Challenges In The Disease Burden of Inpatients Living With HIV In China: A Predictive Study Based On Retrospective Cohort Data

Shuai¹,

Nie²,

Huang³

et al. 2021

Preprint

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Objective: In China, the widespread use of Combination Antiretroviral Therapy (cART) has significantly improved the prognosis and quality of life in people living with HIV(PLWH). However, some PLWH still got worse and were hospitalized for some reasons, including AIDS-Defining Diseases(AD, such as opportunistic infections and AIDS-related Malignancies), Non-AIDS-Defining Diseases (NAD, such as non-AIDS-defining Malignancies and metabolic syndrome). At present, the age and disease of inpatients living with HIV(ILWH) are undergoing some significant changes. For example, the average age of ILWH is gradually increasing, the proportions of ILWH with NAD in all age groups are increasing, and the proportion of ILWH suffering from multiple types of NAD is increasing, which will have a greater impact to both ILWH and infectious disease hospitals. We aim to predict the changes in ILWH in the next 10 years, analyze the impact of such changes on ILWH and infectious disease hospitals in China, and propose corresponding countermeasures.Methods: Based on the 12618 data of ILWH admitted to Chongqing Public Health Medical Center during 2010-2020, We have established a long- and short-term time-series network (LSTNet) deep learning framework based on the Convolution Neural Network (CNN) and the Recurrent Neural Network (RNN). By the framework, we have predicted the age, the proportion of AD and NAD , the proportion of multiple NADs, and the proportion of NAD occurrences in ILWH up to 2030 .Results: Our model showed that the average age of ILWH has risen from 43.8 years in 2010 to 57.6 years in 2030, and the increase in the age of women is greater than that of men. The number of ILWH in different age groups has changed significantly. Among them, the proportion of ILWH under 50 years old has gradually decreased, and the proportion of ILWH over 50 years old has gradually raised. By 2030, the proportion of ILWH over 50 years old will be close to 80%. The proportion of fatal opportunistic infections among ILWH has decreased year by year, and the most common diseases are tuberculosis-related diseases. The proportions of ILWH with only AD or NAD have gradually decreased, and the proportion of ILWH with both AD and NAD has increased year by year. It is estimated that the proportion of all ILWH with both AD and NAD will exceed 80% by 2030. Among all kinds of diseases in NAD, metabolic syndrome will have the highest rate of increase. By 2030, it will account for 16% in all ILWH. The proportion of hepatobiliary and pancreatic system diseases and blood system diseases in NAD will gradually decrease, while the proportion of metabolic syndrome, kidney disease, gastrointestinal disease, non-AIDS defining malignancies(NADM), bone disease and neurological diseases in NAD will gradually increase. The proportion of ILWH with NAD in all age groups will increase significantly after 10 years. Among them, the proportion of ILWH with NAD in 50-60 years old will be more than 80%, and among the ILWH under 30 years old, the proportion of ILWH suffering from NAD will increase to 69.6%. The proportion of ILWH without NAD or only 1 NAD will decrease, while the proportion of ILWH with 3 or more NAD will rise sharply. The proportion of ILWH with 1 type of NAD will drop to 12.6%, while the proportion of ILWH with 2 types of NAD, and the proportion of ILWH with 3 or more types of NAD will increase greatly.Conclusions: Significant changes have took place in the disease burden of ILWH in China, including the aging, the increase in the proportion of ILWH with NAD, and the increase in the proportion of ILWH with multiple types of NAD. These changes mean that in the next 10 years, the diagnosis, treatment and care of ILWH, as well as the development and construction of infectious disease hospitals will all face new challenges. This finding is based on a large number of long-term ILWH data in Chongqing, China, so we can consider that our research strategy can be promoted in China to improve the cure rate and quality of life in ILWH.

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“…For avoiding acute and severe encephalitis, the virus and its interplay with the immune system should keep the interference with the brain structure and function to a low level [ 110 ]. In that respect, one needs to consider that viral infections of the brain may be “asymptomatic” with no short-term effects [ 111 ], but viruses may persist in brain cells over a longer period of time [ 105 , 110 , 112 ]. Accordingly, possible neuroprotective mechanisms for neuronal survival in the course of virus infection may play a role in neuronal persistence of the virus [ 113 ].…”

Section: Virus Infection In the Brainmentioning

confidence: 99%

“…Using post-mortem analysis of patients with chronic HIV infection, Taber et al (2016) reported that HIV infection resulted in activation of microglia cells and astrocytosis in the hippocampus and the neocortex, indicating HIV-related neuroinflammation which possibly induced decreased neurogenesis, as well as neuronal cell death [ 118 ]. Even under antiretroviral therapy (ART), decline in neurocognitive functions, similar to aging, has been described due to persistent HIV brain infections, and named HIV-associated neurocognitive disorders (HAND) [ 112 , 122 , 123 ]. The detailed cellular and molecular mechanisms responsible for HAND have still to be elucidated [ 124 , 125 ].…”

Section: Virus Infection In the Brainmentioning

confidence: 99%

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The Influence of Virus Infection on Microglia and Accelerated Brain Aging

Filgueira

Larionov

Lannes

2021

Cells

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Microglia are the resident immune cells of the central nervous system contributing substantially to health and disease. There is increasing evidence that inflammatory microglia may induce or accelerate brain aging, by interfering with physiological repair and remodeling processes. Many viral infections affect the brain and interfere with microglia functions, including human immune deficiency virus, flaviviruses, SARS-CoV-2, influenza, and human herpes viruses. Especially chronic viral infections causing low-grade neuroinflammation may contribute to brain aging. This review elucidates the potential role of various neurotropic viruses in microglia-driven neurocognitive deficiencies and possibly accelerated brain aging.

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The impact of HIV central nervous system persistence on pathogenesis

Cited by 26 publications

References 126 publications

Future Challenges for Changes in the Disease Burden of Inpatients Living With HIV in China: a Predictive Study

Future Challenges for Changes in the Disease Burden of Inpatients Living With HIV in China: a Predictive Study

Changes And Future Challenges In The Disease Burden of Inpatients Living With HIV In China: A Predictive Study Based On Retrospective Cohort Data

The Influence of Virus Infection on Microglia and Accelerated Brain Aging

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