Effect of human immunodeficiency virus on the brain: a review

Date
2020-11
Journal Title
Journal ISSN
Volume Title
Publisher
American Association for Anatomy
Abstract
Thirty million people are infected with human immunodeficiency virus (HIV) worldwide, and HIV-associated neurocognitive disorder (HAND) is one of the most common comorbidities of HIV. However, the effect of HIV on the brain has not been fully investigated. This article aimed to review the changes to the brain due to HIV in terms of atrophy, diffusion changes, and hyperintensities. Studies have observed significant atrophy in subcortical gray matter, as well as in cortical white and gray matter. Moreover, the ventricles enlarge, and the sulci widen. Although HIV causes changes to the white and gray matter of the brain, few diffusion tensor imaging studies have investigated the changes to gray matter integrity. White and gray matter hyperintensities have frequently been observed in HIV-positive individuals, with the subcortical gray matter (caudate nucleus and putamen) and periventricular white matter frequently affected. In conclusion, subcortical gray matter is the first brain region to be affected and is affected most severely. Additionally, this review highlights the gaps in the literature, since the effect of HIV on the brain is not fully known. Future studies should continue to investigate the effect of HIV on the brain in different stages of the disease, and alternate therapies should be developed since highly active antiretroviral therapy is currently ineffective at treating HAND.
Description
CITATION: Cilliers, K. & Muller, C. J. F. 2021. Effect of human immunodeficiency virus on the brain: A review. The Anatomical Record, 304:1389– 1399. doi:10.1002/ar.24573
The original publication is available at https://anatomypubs.onlinelibrary.wiley.com/journal/19328494
Keywords
HIV infections -- Complications, AIDS dementia complex, Brain matter hyperintensities, Diffusion changes, Subcortical gray matter, Brain -- Diseases
Citation
Cilliers, K. & Muller, C. J. F. 2021. Effect of human immunodeficiency virus on the brain: A review. The Anatomical Record, 304:1389– 1399. doi:10.1002/ar.24573