Psychiatric aspects of HIV and AIDS

HIV-related neurocognitive changes (HRNC) are characterized by a number of different motor and cognitive impairments. Although clinically these abnormalities have been categorized, their underlying neurological basis remains to be elucidated. While neuronal deficits within the frontal cortex of patients with HIV are likely to play a key role in the aetiology of HNRC, the exact mechanisms behind these neuronal losses are not known. In addition, although the incidence of HRNC has decreased in the post-HAART era the prevalence has increased due to prolonged survival times for patients. The aim of this review is to summarize the molecular mechanisms and cell types involved in HIV neuropathological changes and relate these to the individual aspects of HNRC, with a focus on HIV-associated dementia (HAD). The relation of HNRC and HAD will be discussed in the context of other psychiatric disorders and how these disorders relate and impact on patients with HIV. Consideration of psychiatric complications associated with HIV medications will also be discussed, as well as future directions for psychiatric research within the field of HIV.