HIV and COVID-19: two pandemics with significant (but different) central nervous system complications (2024)

Authors

• Shino MagakiSection of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles CA, USA
• Ting ZhangSection of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles CA, USA
• Karam HanSection of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles CA, USA; current affiliation: Department of Pathology and Laboratory Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
• Hilda MirbahaSection of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles CA, USA
• William H. YongDepartment of Pathology and Laboratory Medicine, University of California-Irvine School of Medicine, Irvine, CA, USA
• Cristian AchimDepartment of Psychiatry, University of California San Diego, La Jolla, San Diego, CA, USA
• Gregory FishbeinDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
• Michael C. FishbeinDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
• Omai GarnerDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
• Noriko SalamonDepartment of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
• Christopher K. WilliamsSection of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles CA, USA
• Miguel A. Valdes-SueirasDepartment of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
• Jeffrey J. HsuDivision of Cardiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
• Theodoros KelesidisDepartment of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; current affiliation: Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
• Glenn E. MathisenDepartment of Infectious Diseases, Olive View-University of California Los Angeles Medical Center, Sylmar, CA, USA
• Helen LavretskyDepartment of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
• Elyse J. SingerDepartment of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
• Harry V. VintersSection of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles CA, USA; Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

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Abstract

Human immunodeficiency virus (HIV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause significant neurologic disease. Central nervous system (CNS) involvement of HIV has been extensively studied, with well-documented invasion of HIV into the brain in the initial stage of infection, while the acute effects of SARS-CoV-2 in the brain are unclear. Neuropathologic features of active HIV infection in the brain are well characterized whereas neuropathologic findings in acute COVID-19 are largely non-specific. On the other hand, neuropathologic substrates of chronic dysfunction in both infections, as HIV-associated neurocognitive disorders (HAND) and post-COVID conditions (PCC)/long COVID are unknown. Thus far, neuropathologic studies on patients with HAND in the era of combined antiretroviral therapy have been inconclusive, and autopsy studies on patients diagnosed with PCC have yet to be published. Further longitudinal, multidisciplinary studies on patients with HAND and PCC and neuropathologic studies in comparison to controls are warranted to help elucidate the mechanisms of CNS dysfunction in both conditions.