PSYCHOBIOLOGY OF HIV-INFECTION

This review surveys evidence relevant to the proposition that psychobi ologic factors may influence the progress of infection with human immu nodeficiency virus Type 1 (HIV-1). Little research has directly examin ed the influence of psychobiologic factors on the pathogenetic mechani sms underlying HIV progression. However, basic research in neuroimmune interactions indicates that activation of the sympathetic nervous sys tem and hypothalamic-pituitary-adrenal axis call influence several imm unologic processes relevant to HIV pathogenesis and the body's ability to resist the progress of infection. A small number of observational natural history studies indicate that certain psychosocial characteris tics may be associated with differential disease progression (e.g., su bjective responses to highly threatening events, and inhibited psychos ocial characteristics). We address some of the methodologic and concep tual issues critical to the interpretation of current results as evide nce that psychobiologic processes influence HIV progression, and we co nclude by highlighting promising areas for future inquiry.