HIV and COVID-19: two pandemics with significant (but different) central nervous system complications

doi:10.17879/freeneuropathology-2024-5343

. 2024 Mar 5:5:5-5.

doi: 10.17879/freeneuropathology-2024-5343. eCollection 2024 Jan.

HIV and COVID-19: two pandemics with significant (but different) central nervous system complications

Shino Magaki¹, Ting Zhang¹, Karam Han¹, Mirbaha Hilda¹, William H Yong², Cristian Achim³, Gregory Fishbein⁴, Michael C Fishbein⁴, Omai Garner⁴, Noriko Salamon⁵, Christopher K Williams¹, Miguel A Valdes-Sueiras⁶, Jeffrey J Hsu⁷, Theodoros Kelesidis⁸, Glenn E Mathisen⁹, Helen Lavretsky¹⁰, Elyse J Singer⁶, Harry V Vinters^{1

6

11}

Affiliations

¹ Section of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles CA, USA.
² Department of Pathology and Laboratory Medicine, University of California-Irvine School of Medicine, Irvine, CA, USA.
³ Department of Psychiatry, University of California San Diego, La Jolla, San Diego, CA, USA.
⁴ Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁵ Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁶ Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁷ Division of Cardiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁸ Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁹ Department of Infectious Diseases, Olive View-University of California Los Angeles Medical Center, Sylmar, CA, USA.
¹⁰ Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
¹¹ Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.

PMID: 38469363
PMCID: PMC10925920
DOI: 10.17879/freeneuropathology-2024-5343

HIV and COVID-19: two pandemics with significant (but different) central nervous system complications

Shino Magaki et al. Free Neuropathol. 2024.

. 2024 Mar 5:5:5-5.

doi: 10.17879/freeneuropathology-2024-5343. eCollection 2024 Jan.

Authors

Affiliations

¹ Section of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles CA, USA.
² Department of Pathology and Laboratory Medicine, University of California-Irvine School of Medicine, Irvine, CA, USA.
³ Department of Psychiatry, University of California San Diego, La Jolla, San Diego, CA, USA.
⁴ Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁵ Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁶ Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁷ Division of Cardiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁸ Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁹ Department of Infectious Diseases, Olive View-University of California Los Angeles Medical Center, Sylmar, CA, USA.
¹⁰ Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
¹¹ Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.

PMID: 38469363
PMCID: PMC10925920
DOI: 10.17879/freeneuropathology-2024-5343

Abstract

Human immunodeficiency virus (HIV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause significant neurologic disease. Central nervous system (CNS) involvement of HIV has been extensively studied, with well-documented invasion of HIV into the brain in the initial stage of infection, while the acute effects of SARS-CoV-2 in the brain are unclear. Neuropathologic features of active HIV infection in the brain are well characterized whereas neuropathologic findings in acute COVID-19 are largely non-specific. On the other hand, neuropathologic substrates of chronic dysfunction in both infections, as HIV-associated neurocognitive disorders (HAND) and post-COVID conditions (PCC)/long COVID are unknown. Thus far, neuropathologic studies on patients with HAND in the era of combined antiretroviral therapy have been inconclusive, and autopsy studies on patients diagnosed with PCC have yet to be published. Further longitudinal, multidisciplinary studies on patients with HAND and PCC and neuropathologic studies in comparison to controls are warranted to help elucidate the mechanisms of CNS dysfunction in both conditions.

Keywords: COVID-19; HIV; HIV-associated neurocognitive disorders; Long COVID; Neuropathology; Post-COVID conditions.

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Figures

**Figure 1**
Neuropathologic findings in COVID-19 and HIV infection. A) Acute/subacute microinfarct (arrows) in the internal capsule and B) sparse leptomeningeal (arrow) and parenchymal (arrowhead) T lymphocytes highlighted by CD3 immunohistochemistry in patients with COVID-19. C) HIV encephalitis with multinucleated giant cells (arrows) and D) microglial activation (arrowheads) highlighted by immunohistochemistry for Iba-1 in patients with HIV infection. Scale bars: A = 50 μm, B,D = 100 μm, C = 20 μm

**Figure 2**
Potential mechanisms of neurologic disease in acute/chronic HIV infection and COVID-19/PCC. HAND, HIV-associated neurocognitive disorders; PCC, post-COVID conditions. Figure was created using BioRender.

See this image and copyright information in PMC

References

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[1] Ruelas DS, Greene WC. An integrated overview of HIV-1 latency. Cell 2013;155:519–29. 10.1016/j.cell.2013.09.044. - DOI - PMC - PubMed

[2] Ruelas DS, Greene WC. An integrated overview of HIV-1 latency. Cell 2013;155:519–29. 10.1016/j.cell.2013.09.044. - DOI - PMC - PubMed

[3] Gottlieb MS, Schroff R, Schanker HM, Weisman JD, Fan PT, Wolf RA, et al. Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency. N Engl J Med 1981;305:1425–31. 10.1056/NEJM198112103052401. - DOI - PubMed

[4] Gottlieb MS, Schroff R, Schanker HM, Weisman JD, Fan PT, Wolf RA, et al. Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency. N Engl J Med 1981;305:1425–31. 10.1056/NEJM198112103052401. - DOI - PubMed

[5] Greene WC. A history of AIDS: Looking back to see ahead. Eur J Immunol 2007;37:94–102. 10.1002/eji.200737441. - DOI - PubMed

[6] Greene WC. A history of AIDS: Looking back to see ahead. Eur J Immunol 2007;37:94–102. 10.1002/eji.200737441. - DOI - PubMed

[7] Barré-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gruest J, et al. Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science 1983;220:868–71. 10.1126/science.6189183. - DOI - PubMed

[8] Barré-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gruest J, et al. Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science 1983;220:868–71. 10.1126/science.6189183. - DOI - PubMed

[9] Popovic M, Sarngadharan MG, Read E, Gallo RC. Detection, isolation, and continuous production of cytopathic retroviruses (HTLV-III) from patients with AIDS and pre-AIDS. Science 1984;224:497–500. 10.1126/science.6200935. - DOI - PubMed

[10] Popovic M, Sarngadharan MG, Read E, Gallo RC. Detection, isolation, and continuous production of cytopathic retroviruses (HTLV-III) from patients with AIDS and pre-AIDS. Science 1984;224:497–500. 10.1126/science.6200935. - DOI - PubMed

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HIV and COVID-19: two pandemics with significant (but different) central nervous system complications

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HIV and COVID-19: two pandemics with significant (but different) central nervous system complications

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