Drug abuse and hepatitis C infection as comorbid features of HIV associated neurocognitive disorder: neurocognitive and neuroimaging features

Neuropsychol Rev. 2009 Jun;19(2):215-31. doi: 10.1007/s11065-009-9101-6. Epub 2009 May 27.


Substance abuse and co-infection with hepatitis C (HCV) are two highly relevant determinants of neurocognitive and neuroimaging abnormalities associated with HIV. Substance abuse and HCV are common in the HIV population and there is increasing evidence that the CNS is directly compromised by these comorbid conditions via additive or synergistic processes. In this article we review the current literature regarding mechanisms of neuronal injury as well as the neuropsychological and neuroimaging signatures associated with substance abuse and HCV status among HIV patients. We discuss specific methodological challenges and threats to validity associated with studies of HIV and comorbid substance use disorders or HCV and review potential strategies for minimizing their confounding effects. Efforts to understand the interactions between HIV, substance abuse and HCV co-infection will lead to more complete models of neuropathogenesis of HIV and a greater understanding of the variability in neuropsychological expression of HIV Associated Neurocognitive Disorder.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Acquired Immunodeficiency Syndrome / pathology
  • Acquired Immunodeficiency Syndrome / psychology
  • Brain / pathology
  • Brain / virology
  • Central Nervous System Diseases / etiology*
  • Central Nervous System Diseases / pathology
  • Central Nervous System Diseases / psychology
  • Central Nervous System Diseases / virology
  • Cognition Disorders / etiology*
  • Cognition Disorders / pathology
  • Cognition Disorders / psychology
  • Cognition Disorders / virology
  • Depressive Disorder / complications
  • HIV Infections / complications*
  • HIV Infections / pathology
  • HIV Infections / psychology
  • Hepatitis C / complications*
  • Hepatitis C / pathology
  • Hepatitis C / psychology
  • Humans
  • Substance-Related Disorders / complications*
  • Substance-Related Disorders / pathology
  • Substance-Related Disorders / psychology