What combined effect does cocaine addiction and HIV infection have on the brain?

6th January 2022

It has been widely reported that both drug use (including cocaine) and HIV infection can be associated with brain deficits but researchers are now looking into potential different behaviours in recovering cocaine addicts who are also HIV-positive.

Researchers at the University of Rochester are studying how “the brain puts the ‘brakes’ on behaviour”, the results of which have been published in Neuropharmacology.

John Foxe, Ph.D., director of the Del Monte Institute for Neurosciences and senior author, said: “Scientists have long known that drug abuse can cause damage to the brain. We also know HIV infection can cause brain changes,”

“Since drug use is common in individuals with HIV, an important question is how brain deficits associated with both conditions might add up.”

Researchers used functional magnetic resonance imaging (fMRI) to measure the brain responses of patients recovering from cocaine addiction – including those with and without HIV infection. During the screening, participants played a game that involved purposefully withholding responses to target stimuli.

Kathryn Mary Wakim, Ph.D., a recent graduate from the Neuroscience Graduate Program at the University of Rochester and the first author of the study, added: “The challenging thing about the game we asked participants to play isn’t exactly playing it, per se.

“What’s really hard is not playing the game. What we wanted to measure was how the brain holds back a response under certain task conditions.”

What does it all mean?

The results of this study were telling: those involved in the study diagnosed with HIV and cocaine dependence had a difficult time “holding back behavioural responses,” which is a clear sign of altered brain activity due to addiction and a severe medical condition.

The researchers found that the brain activity during response withholding in recovering cocaine-addicted HIV+ participants was different to brain activity in HIV- participants in recovery.

Mr Foxe said: “Currently when someone who is HIV positive enters a recovery program they are treated in much the same fashion as any other person with an addiction issue.

“But our findings show that they, very likely, need to be treated differently or more intensively.

“HIV and drug addiction should be a dual diagnosis when it comes to recovery, and we will need to design specific targeted intervention approaches for this population, given their unique vulnerability.”

Ms Wakim added that the vast majority of participants in the study contracted HIV via unprotected sex. The potential relapse of HIV+ patients recovering from cocaine addiction should be minimised as much as possible as cocaine use is often associated with risky sexual behaviour, increasing the chance of spreading HIV.

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