Immune activation and neuroinflammation in alcohol use and HIV infection: evidence for shared mechanisms

Background: Emerging research points to innate immune,mechanisms-in the neuropathological and behavioral consequences of heavy alcohol use. Alcohol use is common among people living With HIV infection (PLWH), a chronic condition that carries its Own set of long-term effects on brain and behavior. Notably, neurobiological and cognitive profiles associated with heavy alcohol use and NW infection share several prominent features. This observation-raises questions about interacting biological mechanisms as well as compounded impairment When HIV infection and heavy drinking co-occur. Objective and Method: This narrative overview discusses peek-reviewed research on specific immune mechanisms of alcohol that exhibit apparent potential to compound the neurobiological and psychiatric sequelae of HIV infection. These include microbial translocation, systemic immune activation, blood-brain barrier compromise, microglial activation, and neuroinflammation. Results: Clinical and preclinical evidence supports overlapping mechanistic actions of HIV and alcohol use on peripheral and neural immune systems. In preclinical studies, innate immune signaling mediates many of the-detrimental neurocognitive and behavioral effects of alcohol use. Neuropsycho-pharmacological research suggests potential for a feed-forward cycle in which heavy drinking induces innate immune signaling, which in turn stimulates subsequent alcohol use behavior. Conclusion: Alcohol-induced immune activation and neuroinflammation are a serious health concern for PLWH. Future research to investigate specific immune effects of alcohol in the context of HIV infection has potential to identify novel targets for therapeutic intervention.