Edinburgh Neuroscience, School of Biomedical Sciences, The University of Edinburgh, Edinburgh.
Department of Global Health and Infection, Brighton & Sussex Medical School, University of Sussex, Brighton, UK.
Curr Opin HIV AIDS. 2024 Nov 1;19(6):355-360. doi: 10.1097/COH.0000000000000877. Epub 2024 Jul 10.
Adolescents living with HIV show chronic inflammation, which in turn has been linked to mental health outcomes in the general population. The increased risk for mental health issues in adolescents with HIV may thus be driven by HIV-related inflammation. In this review, we discuss the associations between peripheral and central nervous system inflammation and mental health outcomes in adolescents with HIV.
Preclinical models indicate that expression of HIV viral proteins early in life may lead to neuroinflammation and behavioural deficits in adolescence. Clinical evidence is available primarily in the general population and in adults with HIV, and suggests that inflammatory biomarkers such as IL-6 and TNF-α may be associated with depressive symptoms. Only one study has explored these relationships in adolescents with HIV, and did not find that inflammatory biomarkers in the blood or brain were linked to depressive symptoms. Current research in this field focuses overwhelmingly on peripheral inflammatory biomarkers (compared to neuroimaging biomarkers) and on depression (compared to other mental health conditions).
There is strong evidence to suggest that neuroinflammation and peripheral inflammation may play a role in the development of mental health issues in adolescents, but research in adolescents with HIV is sparse. Characterizing the relationship between inflammation and mental health in adolescents with HIV may help improve the prediction, prevention, early intervention, and treatment of mental health issues in this population.
综述目的：HIV 感染者青少年表现出慢性炎症，而慢性炎症又与普通人群的心理健康结局有关。因此，HIV 感染者青少年出现心理健康问题的风险增加可能是由 HIV 相关炎症引起的。在本综述中，我们讨论了青少年 HIV 感染者外周和中枢神经系统炎症与心理健康结局之间的关联。
最新发现：临床前模型表明，HIV 病毒蛋白在生命早期的表达可能导致青少年时期的神经炎症和行为缺陷。临床证据主要来自普通人群和 HIV 成人患者，表明白细胞介素 6（IL-6）和肿瘤坏死因子-α（TNF-α）等炎症生物标志物可能与抑郁症状有关。只有一项研究探讨了 HIV 感染者青少年的这些关系，并未发现血液或大脑中的炎症生物标志物与抑郁症状有关。目前该领域的研究主要集中在外周炎症生物标志物（与神经影像学生物标志物相比）和抑郁（与其他心理健康状况相比）上。
总结：有强有力的证据表明，神经炎症和外周炎症可能在青少年心理健康问题的发展中起作用，但 HIV 感染者青少年的研究很少。描述 HIV 感染者青少年中炎症与心理健康之间的关系，可能有助于改善该人群心理健康问题的预测、预防、早期干预和治疗。
