Department of Neurology, Johns Hopkins University, Baltimore, Maryland 21287, USA.
Ann N Y Acad Sci. 2010 Feb;1187:122-8. doi: 10.1111/j.1749-6632.2009.05277.x.
Human immunodeficiency virus (HIV) infection in the United States and increasingly in other parts of the world is now being driven by drug-abusing populations. Both HIV infection and drugs of abuse affect the basal ganglia, hippocampal structures, and the prefrontal cortex. Understanding the interactions between the two and their combined effects is critical. In vitro studies show that opiates, methamphetamine, and cocaine can potentiate HIV replication and can enhance or synergize with HIV proteins to cause glial cell activation, neurotoxicity, and breakdown of the blood-brain barrier. Many of these studies have been confirmed in vivo by using rodent models. However, the complexities of polydrug addiction and drug withdrawal have yet to be examined in simian models of HIV-associated neurocognitive disorder. Clinical studies in substance-abusing, HIV-positive patients pose multiple challenges whether aimed at studying disease pathogenesis or conducting clinical trials. This review examines the literature to date, lists the experimental challenges faced by researchers studying effects of drug addiction on HIV neuropathogenesis, and suggests future directions for research.
在美国和世界其他地区，人类免疫缺陷病毒 (HIV) 的感染现在正由滥用药物的人群驱动。HIV 感染和滥用药物都会影响基底神经节、海马结构和前额叶皮层。了解两者之间的相互作用及其综合影响至关重要。体外研究表明，阿片类药物、甲基苯丙胺和可卡因可以增强 HIV 的复制，并可以与 HIV 蛋白协同作用，导致神经胶质细胞激活、神经毒性和血脑屏障破裂。许多这些研究已经通过使用啮齿动物模型得到了证实。然而，HIV 相关神经认知障碍的灵长类动物模型仍有待研究多药成瘾和戒断的复杂性。在滥用药物的 HIV 阳性患者中进行的临床研究无论旨在研究疾病发病机制还是进行临床试验，都面临着多重挑战。这篇综述审查了迄今为止的文献，列出了研究药物成瘾对 HIV 神经发病机制影响的研究人员所面临的实验挑战，并为未来的研究提出了方向。
