Substance abuse, hepatitis C, and aging in HIV: common cofactors that contribute to neurobehavioral disturbances

Randi Melissa Schuster¹, Raul Gonzalez<sup>2

1</sup>Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA; ²Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA

Abstract: Although the prevalence of neurocognitive disturbances among individuals with HIV has decreased in recent years, rates of impairment still remain high. This review presents findings on comorbid conditions that may contribute to further neurocognitive impairments in this already vulnerable population. The authors will focus on three cofactors that have received substantial attention in the neuroAIDS literature: drug use, hepatitis C virus (HCV) coinfection, and aging. All three conditions commonly co-occur with HIV and likely interact with HIV in complex ways. Collectively, the extant literature suggests that drug use, HCV, and aging serve to worsen the neurocognitive profile of HIV through several overlapping mechanisms. A better understanding of how specific comorbidities interact with HIV may reveal specific phenotypes of HIV-associated neurocognitive disorder that may aid in the development of more effective behavioral and pharmacological treatment efforts.

Keywords: drug use, neurocognition, HIV cofactors; HIV-associated neurocognitive disorder (HAND)