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| {{HIV}}
| | #REDIRECT[[AIDS natural history, complications, and prognosis#Cognitive impairment in HIV]] |
| {{CMG}}
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| ==Overview==
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| HIV enters the brain early on in the infection.<ref name=Avison>{{Citation |last1= Avison |first1=MJ|last2= Nath |first2=A|last3= Greene-Avison |first3=R|last4= Schmitt |first4=FA|last5= Greenberg |first5=RN|last6= Berger |first6=JR|title = Neuroimaging correlates of HIV-associated BBB compromise | journal = Journal of Neuroimmunology | volume = 157| issue = 1–2| pages = 140–146 | year = 2004| pmid = 15579291 | doi =10.1016/j.jneuroim.2004.08.025 }}</ref> It is thought that [[HIV]] uses a “Trojan horse” mechanism to enter the brain. Normally, the [[blood brain barrier]] (BBB) serves as a protective mechanism by preventing entry of foreign substances; disruption of the BBB by HIV contributes to the progression of infection.<ref name=Berger>{{Citation |last1= Berger |first1=JR|last2= Avison |first2= MJ | title = The Blood Brain Barrier in HIV Infection | journal = Frontiers in Bioscience | volume = 9| issue = | pages = 2680–2685 | year = 2004| pmid = 15358591 | doi =10.2741/1427 }}</ref> The virus is able to enter the brain through infected cells that pass through the BBB to replace the immune cells surrounding the blood supply in the brain. When infected, immune cells are able to better migrate into tissues compared to uninfected cells. Infected [[microglia]] add to the production of the virus. This activation of the microglia may contribute to the process of neuropathogenesis that spreads the infection to nearby cells.<ref name=Gonzalez>{{Citation |last1= Gonzalez-Scarano |first1=F|last2= Martin-Garcia |first2=J| title = The neuropathogenesis of AIDS | journal = Nature Reviews Immunology | volume = 5| issue = 1| pages = 69–81 | year = 2005| pmid = 15630430 | doi =10.1038/nri1527 }}</ref> Other cells that can get infected include the astrocytes, which can trigger bystander cellular dysfunction and apoptosis, further compromising the blood brain barrier. The toxicity spreads through a gap junction-dependent mechanism.<ref name=Eugenin>{{Citation | last = Eugenin | first = EA | last2 = Clements | first2 = JE | last3 = Zink | first3 = MC | last4 = Berman | first4 = JW | title = Human Immunodeficiency Virus Infection of Human Astrocytes Disrupts Blood-Brain Barrier Integrity by a Gap Junction-Dependent Mechanism | journal = Journal of Neuroscience | volume = | 31 issue = 26| pages = 9456–9465 | year = 2011 | pmid = 21715610 | issue = 26 | pmc = 3132881 }}</ref>
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| ==Reference==
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| {{reflist|2}}
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