With the current national opioid crisis, it is critical to examine the mechanisms underlying pathophysiologic interactions between human immunodeficiency virus (HIV) and opioids in the central nervous system (CNS). Recent advances in experimental models, methodology, and our understanding of disease processes at the molecular and cellular levels reveal opioid-HIV interactions with increasing clarity. However, despite the substantial new insight, the unique impact of opioids on the severity, progression, and prognosis of neuroHIV and HIV-associated neurocognitive disorders (HAND) are not fully understood. In this review, we explore, in detail, what is currently known about mechanisms underlying opioid interactions with HIV, with emphasis on individual HIV-1-expressed gene products at the molecular, cellular and systems levels. Furthermore, we review preclinical and clinical studies with a focus on key considerations when addressing questions of whether opioid-HIV interactive pathogenesis results in unique structural or functional deficits not seen with either disease alone. These considerations include, understanding the combined consequences of HIV-1 genetic variants, host variants, and μ-opioid receptor (MOR) and HIV chemokine co-receptor interactions on the comorbidity. Lastly, we present topics that need to be considered in the future to better understand the unique contributions of opioids to the pathophysiology of neuroHIV.

在当前的国家阿片类药物危机中，至关重要的是检查人类免疫缺陷病毒（HIV）与中枢神经系统（CNS）中阿片类药物之间病理生理相互作用的机制。实验模型，方法论的最新进展以及我们对分子和细胞水平疾病过程的理解揭示了阿片类药物与HIV的相互作用越来越清晰。然而，尽管有了实质性的新见识，但阿片类药物对神经HIV和与HIV相关的神经认知障碍（HAND）的严重性，进展和预后的独特影响尚不完全清楚。在这篇综述中，我们详细探讨了阿片类药物与HIV相互作用的潜在机制，重点是在分子，细胞和系统水平上单独表达HIV-1的基因产物。此外，我们在探讨有关阿片类药物-HIV相互作用的病因是否会导致仅在任何一种疾病中均未见的独特的结构或功能缺陷的问题时，对临床前和临床研究进行了重点研究。这些考虑因素包括了解HIV-1基因变异，宿主变异，μ阿片受体（MOR）和HIV趋化因子共受体相互作用对合并症的综合影响。最后，我们提出了将来需要考虑的主题，以更好地理解阿片类药物对神经HIV病理生理的独特贡献。这些考虑因素包括了解HIV-1基因变异，宿主变异，μ阿片受体（MOR）和HIV趋化因子共受体相互作用对合并症的综合影响。最后，我们提出了将来需要考虑的主题，以便更好地了解阿片类药物对神经HIV病理生理的独特贡献。这些考虑因素包括了解HIV-1基因变异，宿主变异，μ阿片受体（MOR）和HIV趋化因子共受体相互作用对合并症的综合影响。最后，我们提出了将来需要考虑的主题，以便更好地了解阿片类药物对神经HIV病理生理的独特贡献。