Background: There is a strong correlation between the use and abuse of
illicit drugs and the spread of Human Immunodeficiency Virus (HIV). It is well
established that illicit drugs users are a high risk population for infection with HIV
with an increased rate of HIV transmission and replication. Cocaine, amphetamine,
methamphetamine, heroin and morphine stand out as the most frequently abused
illicit drugs and their use correlates well with HIV infection and AIDS progression.
Notably, the high incidence of HIV infection in illicit drug abusers is primarily due
to high risk activities such as needle sharing and unprotected sex. Several studies
have also demonstrated that drugs of abuse increase viral RNA concentrations by
enhancing HIV replication, in particular in the central nervous system (CNS). The
CNS is a common target for both drugs of abuse and HIV, and their synergistic action accelerates
neuronal injury and cognitive impairment. In order to generate complete genomic transcripts, HIV
gene expression has to progress through both the initiation and elongation phases of transcription,
which requires coordinated action of different transcription factors.
Conclusion: In this review, we will provide the latest updates of the molecular mechanisms that
regulate HIV transcription and discuss how drugs of abuse, such as cocaine, amphetamine,
methamphetamine, heroin and morphine, modulate those mechanisms to upregulate HIV transcription
and eventually HIV replication.