Biomarkers in HIV Associated Neurocognitive Disorders

Dear Colleagues,

The advent of antiretroviral therapy (ART) in the early 1990s and the continued development of antiretroviral (ARV) drugs has transformed HIV infection from an almost universally fatal infection to a chronic manageable disease for the majority of people living with HIV (PLWH). However, chronic low level viral infection, inflammation, immune activation, and unintended effects of long-term ART have resulted in frequent metabolic complications in PLWH on ART that include insulin resistance, lipodystrophy, dyslipidemia, increased rates of cardiovascular disease, liver disease, and impairments in some aspects of cognition. It is understood that HIV-1 enters the brain shortly after infection via infected monocytes and blood lymphocytes, which may establish a spectrum of HIV-associated neurocognitive disorders (HAND).

Milder to moderate forms of cognitive impairment and behavioral and motor dysfunctions are commonly seen in HAND in approximately 50 % of PLWH treated with ART. The underlying cause for these residual impairments in cognition remains unclear. Currently, the gold standard for diagnosing and monitoring the progression of cognitive function in HIV-infected patients is neurophysiological testing. Although these tests have been extremely valuable to diagnose and monitor cognitive status, neuropsychological measures can be cohort dependent and require appropriate sets of cultural norms in order to obtain an accurate picture of disease progression. These measures are also relatively insensitive to subtle changes in cognitive status and thus are not ideal surrogate measures for the effectiveness of therapeutics in clinical trials. HAND was reported to be associated with pathological changes in the brain that include generalized atrophy, leukoencephalopathy, viral encephalitis, multinucleated giant cells, neurofilament light chain concentration, amyloid and tau proteins, etc. Nevertheless, there is lack of profound and precise markers which are needed for an accurate diagnosis of HAND. This Special Issue is dedicated to presenting experimental data from current research and reviews on the discovery of biomarkers associated with HAND which will allow advancing our current understanding of HAND pathogenesis.

Dr. Pragney Deme
Dr. Michelino Di Rosa
Guest Editors

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• HIV infection
• Neurological disorders
• Cerebrospinal fluid biomarkers
• Neuroimaging biomarkers
• Plasma biomarkers
• Comorbid conditions (aging, cardiovascular disease, etc.)
• Coinfections (HCV)
• Omics (metabolomics, proteomics, and genomics)