Effects of Antiretroviral Therapy in the Central Nervous System: Beyond Viral Suppression.

Abstract

Persistence of cognitive, behavioral and, to a lesser extent, motor dysfunction in People living with HIV (PLWH) despite viral suppression has raised the question about the potential contribution of antiretroviral (ARV) compounds themselves. Converging clinical and experimental evidence support a contribution of ARV compounds. In this issue we explore the existing clinical evidence on the impact of antiretroviral therapy (ART) on the CNS across the age continuum and in women. We further examine cell type specific effects of ARV drugs as well as the class specific effects. Finally, underlying mechanisms for the observed clinical and experimental ARV-induced effects are discussed. To improve the quality of life for PLWH who are dependent on life-long ART for viral suppression, it is critical to minimize ARV-induced cellular and tissue dysfunction in the CNS.