Could antiretroviral neurotoxicity play a role in the pathogenesis of cognitive impairment in treated HIV disease?

AIDS. 2015 Jan 28;29(3):253-61. doi: 10.1097/QAD.0000000000000538.


Whilst effective antiretroviral therapy is protective against the more severe forms of HIV-associated brain disease, there remains a large burden of clinically symptomatic cognitive impairment in the modern era. Although several potential pathogenic mechanisms have been proposed, the underlying pathology remains elusive. In this review, we summarize the evidence describing neuronal toxicity of antiretroviral agents themselves in both preclinical and clinical situations, as well as the potential pathological mechanisms underlying this toxicity. We also consider the implications for future practice and clinical research in which case determining optimal antiretroviral combinations that effectively suppress HIV replication whilst minimizing neurotoxic effects on the central nervous system may become paramount.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Retroviral Agents / adverse effects*
  • Anti-Retroviral Agents / therapeutic use*
  • Biomedical Research / trends
  • Cognition Disorders / chemically induced*
  • HIV Infections / complications*
  • HIV Infections / drug therapy*
  • Humans


  • Anti-Retroviral Agents