Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198-5880, USA.
Viruses. 2023 May 5;15(5):1117. doi: 10.3390/v15051117.
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative pathogen of the coronavirus disease 2019 (COVID-19) pandemic, a fatal respiratory illness. The associated risk factors for COVID-19 are old age and medical comorbidities. In the current combined antiretroviral therapy (cART) era, a significant portion of people living with HIV-1 (PLWH) with controlled viremia is older and with comorbidities, making these people vulnerable to SARS-CoV-2 infection and COVID-19-associated severe outcomes. Additionally, SARS-CoV-2 is neurotropic and causes neurological complications, resulting in a health burden and an adverse impact on PLWH and exacerbating HIV-1-associated neurocognitive disorder (HAND). The impact of SARS-CoV-2 infection and COVID-19 severity on neuroinflammation, the development of HAND and preexisting HAND is poorly explored. In the present review, we compiled the current knowledge of differences and similarities between SARS-CoV-2 and HIV-1, the conditions of the SARS-CoV-2/COVID-19 and HIV-1/AIDS syndemic and their impact on the central nervous system (CNS). Risk factors of COVID-19 on PLWH and neurological manifestations, inflammatory mechanisms leading to the neurological syndrome, the development of HAND, and its influence on preexisting HAND are also discussed. Finally, we have reviewed the challenges of the present syndemic on the world population, with a particular emphasis on PLWH.
严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)是导致 2019 年冠状病毒病(COVID-19)大流行的病原体,这是一种致命的呼吸道疾病。COVID-19 的相关危险因素包括年龄较大和合并医学疾病。在当前联合抗逆转录病毒疗法(cART)时代,相当一部分病毒载量得到控制的 HIV-1 感染者(PLWH)年龄较大且合并有合并症,使这些人容易感染 SARS-CoV-2 并发生 COVID-19 相关的严重后果。此外,SARS-CoV-2 具有神经嗜性并引起神经系统并发症,给 PLWH 带来健康负担并对其产生不利影响,使 HIV-1 相关神经认知障碍(HAND)恶化。SARS-CoV-2 感染和 COVID-19 严重程度对神经炎症、HAND 的发展以及先前存在的 HAND 的影响尚未得到充分探索。在本综述中,我们汇集了 SARS-CoV-2 和 HIV-1 之间的差异和相似之处、SARS-CoV-2/COVID-19 和 HIV-1/AIDS 综合征的情况及其对中枢神经系统(CNS)的影响的现有知识。还讨论了 COVID-19 对 PLWH 的危险因素和神经系统表现、导致神经综合征的炎症机制、HAND 的发展及其对先前存在的 HAND 的影响。最后,我们回顾了当前大流行对世界人口的挑战,特别强调了 PLWH。
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