Role of HIV in amyloid metabolism

Mario Ortega, Beau M. Ances

Research output: Contribution to journalReview articlepeer-review

33 Scopus citations

Abstract

HIV infection has changed from an acute devastating disease to a more chronic illness due to combination anti-retroviral treatment (cART). In the cART era, the life expectancy of HIV-infected (HIV+) individuals has increased. More HIV+individuals are aging with current projections suggesting that 50 % of HIV+individuals will be over 50 years old by 2015. With advancing age, HIV+individuals may be at increased risk of developing other potential neurodegenerative disorders [especially Alzheimer's disease (AD)]. Pathology studies have shown that HIV increases intra and possibly extracellular amyloid beta (Aβ42), a hallmark of AD. We review the synthesis and clearance of Aβ42; the effects of HIV on the amyloid pathway; and contrast the impact of AD and HIV on Aβ42 metabolism. Biomarker studies (cerebrospinal fluid AB and amyloid imaging) in HIV+participants have shown mixed results. CSF Aβ42 has been shown to be either normal or diminished in with HIV associated neurocognitive disorders (HAND). Amyloid imaging using [11C] PiB has also not demonstrated increased extracellular amyloid fibrillar deposits in HAND. We further demonstrate that Aβ42 deposition is not increased in older HIV+participants using [11C] PiB amyloid imaging. Together, these results suggest that HIV and aging each independently affect Aβ42 deposition with no significant interaction present. Older HIV+individuals are probably not at increased risk for developing AD. However, future longitudinal studies of older HIV+individuals using multiple modalities (including the combination of CSF markers and amyloid imaging) are necessary for investigating the effects of HIV on Aβ42 metabolism.

Original languageEnglish
Pages (from-to)483-491
Number of pages9
JournalJournal of Neuroimmune Pharmacology
Volume9
Issue number4
DOIs
StatePublished - Sep 2014

Keywords

  • Amyloid
  • Amyloid imaging
  • CNS
  • Cerebrospinal fluid (CSF)
  • Combination anti-retroviral therapy (cART)
  • HIV
  • HIV associated neurocognitive disorders (HAND)

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