Title:Neurological Complications Caused by Human Immunodeficiency Virus (HIV) and Associated Opportunistic Co-infections: A Review on their
Diagnosis and Therapeutic Insights
Volume: 23
Issue: 3
Author(s): Sivaraman Balaji, Rohan Chakraborty and Sumit Aggarwal*
Affiliation:
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research-Headquarters, Ansari
Nagar, New Delhi, 110029, India
Keywords:
Human immunodeficiency virus, antiretroviral therapy, HIV associated neurological disorder, central nervous system, co-infections, blood-brain barrier.
Abstract: Neurocognitive disorders associated with human immunodeficiency virus (HIV) infected
individuals increase the risk of mortality and morbidity that remain a prevalent clinical complication
even in the antiretroviral therapy era. It is estimated that a considerable number of people in the HIV
community are developing neurological complications at their early stages of infection. The daily lives
of people with chronic HIV infections are greatly affected by cognitive declines such as loss of attention,
learning, and executive functions, and other adverse conditions like neuronal injury and dementia.
It has been found that the entry of HIV into the brain and subsequently crossing the blood-brain
barrier (BBB) causes brain cell damage, which is the prerequisite for the development of neurocognitive
disorders. Besides the HIV replication in the central nervous system and the adverse effects of antiretroviral
therapy on the BBB, a range of opportunistic infections, including viral, bacterial, and parasitic
agents, augment the neurological complications in people living with HIV (PLHIV). Given the
immuno-compromised state of PLHIV, these co-infections can present a wide range of clinical syndromes
with atypical manifestations that pose challenges in diagnosis and clinical management, representing
a substantial burden for the public health system. Therefore, the present review narrates the
neurological complications triggered by HIV and their diagnosis and treatment options. Moreover, coinfections
that are known to cause neurological disorders in HIV infected individuals are highlighted.