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Despite this, high rates of non-infectious comorbidities persist in treated people with HIV, hypothesized to be related to persistent immuno-activation. One such comorbidity is cognitive impairment, which may partly be driven by ongoing neuro-inflammation in otherwise effectively treated people with HIV. In order to develop therapeutic interventions to address neuro-inflammation in effectively treated people with HIV, a deeper understanding of the pathogenic mechanisms driving persistent neuro-inflammatory responses and the ability to better characterize and measure neuro-inflammation in the central nervous system is required. This review highlights recent advances in molecular neuroimaging techniques which have the potential to assess neuro-inflammatory responses within the central nervous system in HIV disease. Proton magnetic resonance spectroscopy (1H-MRS) has been utilized to assess neuro-inflammatory responses since early in the HIV pandemic and shows promise in recent studies assessing different antiretroviral regimens. 1H-MRS is widely available in both resource-rich and some resource-constrained settings and is relatively inexpensive. Brain positron emission tomography (PET) imaging using Translocator Protein (TSPO) radioligands is a rapidly evolving field; newer TSPO-radioligands have lower signal-to-noise ratio and have the potential to localize neuro-inflammation within the brain in people with HIV. As HIV therapeutics evolve, people with HIV continue to age and develop age-related comorbidities including cognitive disorders. The use of novel neuroimaging modalities in the field is likely to advance in order to rapidly assess novel therapeutic interventions and may play a role in future clinical assessments.<\/jats:p>","DOI":"10.1093\/cei\/uxab013","type":"journal-article","created":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T18:52:08Z","timestamp":1642013528000},"page":"14-23","source":"Crossref","is-referenced-by-count":9,"title":["Molecular neuroimaging of inflammation in HIV"],"prefix":"10.1093","volume":"210","author":[{"given":"Jasmini","family":"Alagaratnam","sequence":"first","affiliation":[{"name":"Department of Infectious Disease, Faculty of Medicine, Imperial College London , London , UK"},{"name":"Department of Genitourinary Medicine & HIV, St Mary\u2019s Hospital, Imperial College Healthcare NHS Trust , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Winston","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Faculty of Medicine, Imperial College London , London , UK"},{"name":"Department of Genitourinary Medicine & HIV, St Mary\u2019s Hospital, Imperial College Healthcare NHS Trust , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"key":"2023012104394020800_CIT0001","doi-asserted-by":"crossref","first-page":"15035","DOI":"10.1038\/nrdp.2015.35","article-title":"HIV infection.","volume":"1","author":"Deeks","year":"2015","journal-title":"Nat Rev Dis Primers"},{"key":"2023012104394020800_CIT0002","doi-asserted-by":"crossref","first-page":"e349","DOI":"10.1016\/S2352-3018(17)30066-8","article-title":"Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies","volume":"4","author":"Trickey","year":"2017","journal-title":"Lancet HIV"},{"key":"2023012104394020800_CIT0003"},{"key":"2023012104394020800_CIT0004","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/S0891-5520(05)70135-5","article-title":"Natural history of HIV-1 infection.","volume":"14","author":"Vergis","year":"2000","journal-title":"Infect Dis Clin North Am"},{"key":"2023012104394020800_CIT0005","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/S0140-6736(85)91205-X","article-title":"Acute AIDS retrovirus infection. 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