Increased dopaminergic neurotransmission in therapy-naïve asymptomatic HIV patients is not associated with adaptive changes at the dopaminergic synapses.

Central dopaminergic (DA) systems are affected during human immunodeficiency virus (HIV) infection. So far, it is believed that they degenerate with progression of HIV disease because deterioration of DA systems is evident in advanced stages of infection. In this manuscript we found that (a) DA levels are increased and DA turnover is decreased in CSF of therapy-naïve HIV patients in asymptomatic infection, (b) DA increase does not modulate the availability of DA transporters and D2-receptors, (c) DA correlates inversely with CD4+ numbers in blood. These findings show activation of central DA systems without development of adaptive responses at DA synapses in asymptomatic HIV infection. It is probable that DA deterioration in advanced stages of HIV infection may derive from increased DA availability in early infection, resulting in DA neurotoxicity. Our findings provide a clue to the synergism between DA medication or drugs of abuse and HIV infection to exacerbate and accelerate HIV neuropsychiatric disease, a central issue in the neurobiology of HIV.

[Neurological manifestations of the HIV infection]. / Immer häufiger und in immer mehr klinischen Erscheinungsformen. Neurologische Manifestationen der HIV-Infektion.

As a result of improved therapeutic possibilities with highly active antiretroviral therapy (HAART), an increasing prevalence of neurological complications of the HIV infection is observed. In particular, some authors now also describe a "morphogenesis" of the HIV-1-related encephalopathy. The current state of knowledge should be taken into account in the diagnostics and therapy of HIV-1-related encephalopathy, depression, progressive multifocal leukencephalopathy and polyneuropathy.