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Pathogenic mechanisms of human immunodeficiency virus (HIV)-associated pain

Molecular Psychiatry volume 28, pages 3613–3624 (2023)Cite this article

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Abstract

Chronic pain is a prevalent neurological complication among individuals living with human immunodeficiency virus (PLHIV) in the post-combination antiretroviral therapy (cART) era. These individuals experience malfunction in various cellular and molecular pathways involved in pain transmission and modulation, including the neuropathology of the peripheral sensory neurons and neurodegeneration and neuroinflammation in the spinal dorsal horn. However, the underlying etiologies and mechanisms leading to pain pathogenesis are complex and not fully understood. In this review, we aim to summarize recent progress in this field. Specifically, we will begin by examining neuropathology in the pain pathways identified in PLHIV and discussing potential causes, including those directly related to HIV-1 infection and comorbidities, such as antiretroviral drug use. We will also explore findings from animal models that may provide insights into the molecular and cellular processes contributing to neuropathology and chronic pain associated with HIV infection. Emerging evidence suggests that viral proteins and/or antiretroviral drugs trigger a complex pathological cascade involving neurons, glia, and potentially non-neural cells, and that interactions between these cells play a critical role in the pathogenesis of HIV-associated pain.

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Funding

The work in the Tang laboratory described in this paper was supported by NIH grants: R01NS079166, R01DA036165, R01NS095747, R01DA050530, R01NS122571, and R01DA057195.

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Authors and Affiliations

  1. Stony Brook University Pain and Analgesia Research Center (SPARC), Stony Brook University, Stony Brook, 11794, NY, USA

    Xin Liu & Shao-Jun Tang

  2. Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, 11794, NY, USA

    Xin Liu & Shao-Jun Tang

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  1. Xin Liu
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Correspondence to Shao-Jun Tang.

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Liu, X., Tang, SJ. Pathogenic mechanisms of human immunodeficiency virus (HIV)-associated pain. Mol Psychiatry 28, 3613–3624 (2023). https://doi.org/10.1038/s41380-023-02294-7

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