HIV-1 infection and its impact on the HPA axis, cytokines, and cognition

Mahendra Kumar, Adarsh Kumar, Drenna Waldrop, Michael H Antoni, Carl Eisdorfer

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Immediately after infection, Human immunodeficiency virus, type 1 (HIV-1) enters the central nervous system (CNS) and is localized in highest concentration in the hippocampus and basal ganglia. Since these areas are associated with HPA axis and autonomic activities as well as cognition, it has been hypothesized that these functions will be impacted adversely in HIV-1 infection. In the treatment of HIV infection, although the highly potent antiretroviral (HAART) drugs have been effective in reducing peripheral viral load and prolonging life expectancy, these drugs do not cross the blood-brain barrier in therapeutic concentrations. Therefore, it has been proposed that the beneficial effects of HAART on the CNS will be limited. Our investigations on seropositive individuals, showing hypo-reactivity of the autonomic system and HPA axis activity suggest that HIV-1 infection is a model of chronic stress. Furthermore, an elevated baseline TNF-alpha level as well as its increased reactivity to an alpha-adrenergic challenge among HIV-1+ individuals, may lead to additional neurodegeneration. It is proposed that the effects of HIV-1 infection on the brain will have implications for neurocognitive and mental health functioning in seropositive individuals even in patients undergoing HAART therapy. These outcomes may result in the need to develop facilities for long term "care-giving".

Original languageEnglish
Pages (from-to)167-172
Number of pages6
JournalStress
Volume6
Issue number3
DOIs
StatePublished - Sep 1 2003

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Virus Diseases
Cognition
HIV-1
Cytokines
Highly Active Antiretroviral Therapy
Central Nervous System
Long-Term Care
Life Expectancy
Basal Ganglia
Blood-Brain Barrier
Viral Load
Pharmaceutical Preparations
Adrenergic Agents
HIV Infections
Hippocampus
Mental Health
Therapeutics
Tumor Necrosis Factor-alpha
Brain
Infection

Keywords

  • AIDS
  • Cytokines
  • HIV-1
  • Neurodegeneration
  • Stress hyporesponsiveness

ASJC Scopus subject areas

  • Neuroscience(all)
  • Physiology

Cite this

HIV-1 infection and its impact on the HPA axis, cytokines, and cognition. / Kumar, Mahendra; Kumar, Adarsh; Waldrop, Drenna; Antoni, Michael H; Eisdorfer, Carl.

In: Stress, Vol. 6, No. 3, 01.09.2003, p. 167-172.

Research output: Contribution to journalArticle

Kumar, Mahendra ; Kumar, Adarsh ; Waldrop, Drenna ; Antoni, Michael H ; Eisdorfer, Carl. / HIV-1 infection and its impact on the HPA axis, cytokines, and cognition. In: Stress. 2003 ; Vol. 6, No. 3. pp. 167-172.
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