Psychiatric comorbidities in HIV/AIDS patients and its overlap with neurological disorders

Abstract

The prevalence of psychiatric and neurological disorders in populations with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) presents significant public health concerns including impaired quality of life, reduced antiretroviral therapy (ART) adherence, and elevated morbidity and mortality rates. Research suggests that these correlations translate to millions of people globally, given that over 25 million people are living with HIV/AIDS in the African region alone. This article explores the overlap in clinical presentation and pathophysiology between psychiatric and neurological conditions and seeks to fill current knowledge gaps regarding their co-occurrence, misdiagnosis, and impact on treatment outcomes. A comprehensive literature review was conducted employing electronic search databases comprising PubMed/MEDLINE, ResearchGate, and related databases, using keywords such as “psychiatric disorders,” “neurological disorders,” “HIV,” “AIDS,” and “comorbidities”. Studies were selected based on relevance to the overlap of psychiatric and neurological conditions in HIV/AIDS. Neurological disorders like HIV-Associated Neurocognitive Disorders (HAND) were observed in 20–50% of HIV/AIDS patients. Similarly, the prevalence of psychiatric symptoms, such as depression and anxiety, among HIV/AIDS patients was reported at 32.9% and 27.4% respectively. Also, overlapping pathophysiological processes, such as neuroinflammation, immune dysregulation, and HIV-related neurotoxicity, were identified as common mechanisms underpinning both psychiatric and neurological disorders in HIV/AIDS patients. Multidisciplinary collaborations are warranted to create tailored antiretroviral therapy regimens that minimize neurotoxicity and further investigate the neuropsychiatric overlap to enhance diagnostic accuracy and patient outcomes.