Psychosocial influences on HIV-1 disease progression: neural, endocrine, and virologic mechanisms.

TitlePsychosocial influences on HIV-1 disease progression: neural, endocrine, and virologic mechanisms.
Publication TypeJournal Article
Year of Publication2008
AuthorsCole SW
JournalPsychosom Med
Date Published2008 Jun
KeywordsAdaptation, Psychological, Animals, Behavior Therapy, Disease Models, Animal, Disease Progression, Epinephrine, HIV Infections, HIV-1, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Life Change Events, Norepinephrine, Patient Care Team, Psychoneuroimmunology, Sick Role, Sympathetic Nervous System, Virus Replication

This review surveys empirical research pertinent to the hypothesis that activity of the hypothalamus-pituitary-adrenal (HPA) axis and/or the sympathetic nervous system (SNS) might mediate biobehavioral influences on HIV-1 pathogenesis and disease progression. Data are considered based on causal effects of neuroeffector molecules on HIV-1 replication, prospective relationships between neural/endocrine parameters and HIV-relevant biological or clinical markers, and correlational data consistent with in vivo neural/endocrine mediation in human or animal studies. Results show that HPA and SNS effector molecules can enhance HIV-1 replication in cellular models via effects on viral infectivity, viral gene expression, and the innate immune response to infection. Animal models and human clinical studies both provide evidence consistent with SNS regulation of viral replication, but data on HPA mediation are less clear. Regulation of leukocyte biology by neuroeffector molecules provides a plausible biological mechanism by which psychosocial factors might influence HIV-1 pathogenesis, even in the era of effective antiretroviral therapy. As such, neural and endocrine parameters might provide useful biomarkers for gauging the promise of behavioral interventions and suggest novel adjunctive strategies for controlling HIV-1 disease progression.

Alternate JournalPsychosom Med
PubMed ID18541906
Grant ListR01 AI52737 / AI / NIAID NIH HHS / United States
R01 CA116778 / CA / NCI NIH HHS / United States