Molecular Studies of Neurodegenerative Diseases Lab, FELS Institute for Cancer Research and Molecular Biology, Philadelphia, Pennsylvania, USA.
Department of Neurology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA.
AIDS Rev. 2019;21(2):76-83. doi: 10.24875/AIDSRev.19000051.
With the introduction of combinatory antiretroviral therapy, patients infected with human immunodeficiency virus type 1 (HIV-1) can live much longer than before. However, the identification of HIV-associated neurocognitive disorder (HAND), especially HIV-associated dementia in 15-20% of patients infected with HIV-1, indicates additional complexity. These disorders turn out to be subtype dependent. Recently, many studies are ongoing trying to understand how the virus induces neuronal injury which could lead to neurological dysfunction. Most of these studies are focusing on the HIV-1 release of proteins such as Tat. However, the exact role of these proteins and their involvement in neuronal degeneration remains unidentified; this is especially true since viral proteins from different HIV-1 subtypes differ in their ability to cause neuronal damage. This review describes the role of different HIV-1 subtypes, identifies probable pathways involved in neuronal damage, the contribution of different HIV-1 subtypes to the progression of HAND, and potential treatments for HAND.
随着联合抗逆转录病毒疗法的引入,感染人类免疫缺陷病毒 1 型(HIV-1)的患者的寿命比以前长了很多。然而,HIV 相关认知障碍(HAND)的鉴定,特别是在 15-20%的 HIV-1 感染者中出现的 HIV 相关痴呆,表明存在额外的复杂性。这些障碍表现为亚型依赖性。最近,许多研究正在进行,试图了解病毒如何诱导神经元损伤,从而导致神经功能障碍。这些研究大多集中在 HIV-1 释放蛋白质,如 Tat。然而,这些蛋白质的确切作用及其在神经元退化中的作用仍未确定;特别是因为不同 HIV-1 亚型的病毒蛋白在引起神经元损伤的能力上存在差异。这篇综述描述了不同 HIV-1 亚型的作用,确定了参与神经元损伤的可能途径,不同 HIV-1 亚型对 HAND 进展的贡献,以及 HAND 的潜在治疗方法。