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Impact of tobacco smoke in HIV progression: a major risk factor for the development of NeuroAIDS and associated CNS disorders

  • Aditya Bhalerao
  • Luca CuculloEmail author
Review Article
  • 30 Downloads

Abstract

Aim

The advent of highly active antiretroviral therapy (HAART) and combined antiretroviral therapy (cART) has substantially increased the life expectancy of patients infected with human immunodeficiency virus (HIV). However, this has brought into sharp contrast the incidence of several non-acquired immunodeficiency syndrome (non-AIDS) diseases such as NeuroAIDS, which identifies a group of neurological disorders caused primarily by HIV-mediated damage to the central and peripheral nervous systems. Given the patients’ depleted immune condition, the use and abuse of drug and addictive substances such as tobacco smoking can further deteriorate their overall health and accelerate the progression and severity of the disease. In this review, we detail the pathogenesis, progression, and characteristics of HIV, and the impact of tobacco smoking as a risk factor for the progression of the disease to NeuroAIDS. This is a poorly understood aspect of HIV-related complications that needs to be addressed.

Subjects and methods

Review of theoretical approaches and knowledge synthesis.

Results

Tobacco smoking is highly prevalent in HIV patients when compared to the general population. The oxidative damage and inflammatory stress caused by chronic smoking on the cerebrovascular system have been well established. Considering that HIV patients have an impaired immune system and smokers per se are more susceptible to viral and bacterial inflammatory neuropathologies than non-smokers, it is conceivable that tobacco smoking is a risk factor for the progression of HIV into NeuroAIDS and related neurological impairments.

Conclusion

Tobacco smoke (TS) may bring about a synergistic effect in the context of persistent inflammatory state and cerebrovascular damage which facilitate HIV infection and progression to NeuroAIDS when compared to non-smokers.

Keywords

Blood–brain barrier Oxidative stress Inflammation Smoking Brain disorders Abuse Cognitive 

Abbreviations

AIDS

Acquired immunodeficiency syndrome

AP-1

Activator protein 1

ART

Antiretroviral therapy

BBB

Blood–brain barrier

BKCa

Large conductance, Ca2 + --activated K+ Channels

IL-8

Interleukin 8

FOSL1

High FOS-like antigen 1

FOSL2

High FOS-like antigen 2

CNS

Central nervous system

OS

Oxidative stress

TS

TS

AIDS

Acquired immunodeficiency syndrome

HIV

Human immunodeficiency virus

HAART

Highly active antiretroviral therapy

cART

Combined antiretroviral therapy

ADC

AIDS dementia complex

HIVCMC

HIV-associated cognitive–motor complex

HAND

HIV-associated neurocognitive disorders

CRP

C-reactive protein

ROS

Reactive oxygen species

PTKs

Protein tyrosine kinases

GF1

Transforming growth factor type 1

Notes

Acknowledgements

This work was supported by the National Institutes of Health/ National Institute on Drug Abuse 2R01-DA029121-01A1 to Dr. Luca Cucullo.

Contributions

A.B. prepared the draft of the manuscript, figure preparations. L.C. conceived the study, assisted with data interpretation, drafting of the manuscript, and preparation of the figures. L.C. also oversaw the research study and provided funding. Both authors reviewed the manuscript.

Compliance with ethical standards

Competing interests

The authors declare no competing interests.

Ethical approval

This article does not contain any studies with human participants or animals performed by the author.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pharmaceutical SciencesTexas Tech University Health Sciences CenterAmarilloUSA
  2. 2.Center for Blood–Brain Barrier ResearchTexas Tech University Health Sciences CenterAmarilloUSA
  3. 3.Pharmaceutical Sciences, Texas Tech University Health Sciences CenterSchool of PharmacyAmarilloUSA

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