Abstract
With the introduction of combination antiretroviral therapy, many human immunodeficiency
virus-positive (HIV+) individuals are reaching advanced age. The proportion of people
living with HIV older than 50 years already exceeds 50% in many communities, and is
expected to reach this level nationally by 2015. HIV and aging are independently associated
with neuropathological changes, but their concurrence may have a more deleterious
effect on the central nervous system (CNS). Published data about neurocognitive and
neuroimaging markers of HIV and aging are reviewed. Putative factors contributing
to neurocognitive impairment and neuroimaging changes in the aging HIV+ brain, such
as metabolic disturbances, cardiovascular risk factors, immune senescence, and neuroinflammation,
are described. The possible relationship between HIV and some markers of Alzheimer's
disease is presented. Current research findings emphasize multiple mechanisms related
to HIV and combination antiretroviral therapy that compromise CNS structure and function
with advancing age.
Keywords
human immunodeficiency virus - aging - neurocognitive - neuroimaging - metabolic syndrome