Methamphetamine and Cannabis: A Tale of Two Drugs and their Effects on HIV, Brain, and Behavior
- PDF / 1,411,240 Bytes
- 22 Pages / 595.276 x 790.866 pts Page_size
- 25 Downloads / 185 Views
INVITED REVIEW
Methamphetamine and Cannabis: A Tale of Two Drugs and their Effects on HIV, Brain, and Behavior Rowan Saloner 1,2 & Jerel Adam Fields 1 & Maria Cecilia Garibaldi Marcondes 3 & Jennifer E. Iudicello 1 & Sofie von Känel 1 & Mariana Cherner 1 & Scott L. Letendre 1 & Marcus Kaul 1,4 & Igor Grant 1 & the Translational Methamphetamine AIDS Research Center (TMARC) Group Received: 15 June 2020 / Accepted: 10 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract HIV infection and drug use intersect epidemiologically, and their combination can result in complex effects on brain and behavior. The extent to which drugs affect the health of persons with HIV (PWH) depends on many factors including drug characteristics, use patterns, stage of HIV disease and its treatment, comorbid factors, and age. To consider the range of drug effects, we have selected two that are in common use by PWH: methamphetamine and cannabis. We compare the effects of methamphetamine with those of cannabis, to illustrate how substances may potentiate, worsen, or even buffer the effects of HIV on the CNS. Data from human, animal, and ex vivo studies provide insights into how these drugs have differing effects on the persistent inflammatory state that characterizes HIV infection, including effects on viral replication, immune activation, mitochondrial function, gut permeability, blood brain barrier integrity, glia and neuronal signaling. Moving forward, we consider how these mechanistic insights may inform interventions to improve brain outcomes in PWH. Keywords HIV-associated neurocognitive disorders . Methamphetamine . Cannabis . Inflammation . Blood-brain-barrier . Gut-brain-axis
Introduction Despite the success of combined antiretroviral therapy (cART) in prolonging the lifespan of persons with HIV (PWH), HIV-associated neurocognitive disorders (HAND) remain prevalent. HIV-associated dementia, a more severe complication from the persistence of HIV in the brain, has become relatively rare since the introduction of cART. * Rowan Saloner [email protected] 1
Department of Psychiatry, HIV Neurobehavioral Research Program, University of California, San Diego, San Diego, CA, USA
2
Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego , San Diego, CA, USA
3
San Diego Biomedical Research Institute, San Diego, CA, USA
4
Division of Biomedical Sciences, University of California, Riverside, Riverside, CA, USA
However, milder forms of HAND, specifically asymptomatic neurocognitive impairment and mild neurocognitive disorder, have been reported in 30–50% of PWH, even despite suppressive ART, and can affect quality of life as well as everyday function (Heaton et al. 2010; Heaton et al. 2011; Saloner and Cysique 2017). The profile of HAND is heterogeneous; fronto-striatal dysfunction, manifested by disruptions in planning and reasoning (executive function) is most commonly observed, but problems in learning and memory, reduction in speed and efficie
Data Loading...
