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CNS Neurotoxicity of Antiretrovirals

  • Invited Review
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Abstract

The development of novel antiretroviral treatments has led to a significant turning point in the fight against HIV. Although therapy leads to virologic suppression and prolonged life expectancies, HIV-associated neurocognitive disorder (HAND) remains prevalent. While various hypotheses have been proposed to explain this phenomenon, a growing body of literature explores the neurotoxic effects of antiretroviral therapy. Research to date brings into question the potential role of such medications in neurocognitive and neuropsychiatric impairment seen in HIV-positive patients. This review highlights recent findings and controversies in cellular, molecular, and clinical neurotoxicity of antiretrovirals. It explores the pathogenesis of such toxicity and relates it to clinical manifestations in each medication class. The concept of accelerated aging in persons living with HIV (PLWH) as well as potential treatments for HAND are also discussed. Ultimately, this article hopes to educate clinicians and basic scientists about the neurotoxic effects of antiretrovirals and spur future scientific investigation into this important topic.

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  1. Department of Neurosciences, University of California San Diego School of Medicine, 200 W Arbor Dr, San Diego, La Jolla, CA, 92103, USA

    Tyler Lanman & Ronald Ellis

  2. Department of Infectious Diseases, University of California San Diego School of Medicine, La Jolla, CA, USA

    Scott Letendre

  3. Pharmacotherapy Research Center, University of Buffalo, School of Pharmacy & Pharmaceutical Sciences, Buffalo, NY, USA

    Qing Ma

  4. Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA

    Anne Bang

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Lanman, T., Letendre, S., Ma, Q. et al. CNS Neurotoxicity of Antiretrovirals. J Neuroimmune Pharmacol 16, 130–143 (2021). https://doi.org/10.1007/s11481-019-09886-7

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