Abstract
Despite major advances in HIV-1 treatment, the prevalence of HIV-associated neurocognitive disorders (HAND) remains a problem, particularly as individuals on suppressive treatment continue to live longer. To facilitate discussion on emerging and future directions in HAND research, a meeting was held in Durban, South Africa in March 2015 as part of the Society of Neuroscientists of Africa (SONA) conference. The objective of the meeting was to assess the impact of HIV subtype diversity on HAND and immunological dysfunction. The meeting brought together international leaders in the area of neurological complications of HIV-1 infection with special focus on the African population. Research presentations indicated that HAND was highly prevalent and that inflammatory cytokines and immune-activation played important roles in progression of neurocognitive impairment. Furthermore, children on antiretroviral therapy were also at risk for developing neurocognitive impairment. With respect to the effect of HIV-1 subtype diversity, analyses of HIV-1 clade C infection among South Africans revealed that clade C infection induced cognitive impairment that was independent of the substitution in HIV-1 Trans-Activator of Transcription (Tat; C31S). At the cellular level, a Zambian study showed that clade C infection resulted in reduced brain cell death compared with clade B infection suggesting clade specific variations in mediating brain cell injury. Furthermore, ex vivo Tat protein from clade CRF02_AG, prevalent in West/ Central Africa, exhibited reduced disruption of brain endothelium compared with clade B Tat protein. Discussions shed light on future research directions aimed at understanding biomarkers and disease mechanisms critical for HAND.
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Acknowledgments
We thank the following for their support of the workshop held in Durban in March 2015:
National Institute of Mental Health (NIMH)
Society of Neuroscientists of Africa (SONA)
We thank all patients who participated in these studies.
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This work was written as part of Dr. Jeymohan Joseph’s official duties as a government employee. The views expressed in this article do not necessarily represent views of NIMH, NIH, HHS, or the United States Government.
Funding
The authors acknowledge funding from National Institutes of Health: MH094160 (to GDK); DA036157 (to SB).
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Buch, S., Chivero, E.T., Hoare, J. et al. Proceedings from the NIMH symposium on “NeuroAIDS in Africa: neurological and neuropsychiatric complications of HIV”. J. Neurovirol. 22, 699–702 (2016). https://doi.org/10.1007/s13365-016-0467-y
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DOI: https://doi.org/10.1007/s13365-016-0467-y