Where Does HIV Hide? A Focus on the Central Nervous System

Overview

Journal Curr Opin HIV AIDS

Specialty Infectious Diseases

Date 2013 Feb 23

PMID 23429501

Citations 86

Authors

Melissa Churchill

Avindra Nath

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: To review the literature on infection and evolution of HIV within the brain in the context for understanding the nature of the brain reservoir and its consequences.

Recent Findings: HIV-1 in the brain can evolve in separate compartments within macrophage/microglia and astrocytes. The virus adapts to the brain environment to infect these cells and brain-specific mutations can be found in nearly all genes of the virus. The virus evolves to become more neurovirulent.

Summary: The brain is an ideal reservoir for the HIV. The brain is a relatively immune privileged site and the blood-brain barrier prevents easy access to antiretroviral drugs. Further, the virus infects resident macrophages and astrocytes which are long-lived cells and causes minimal cytopathology in these cells. Hence as we move towards developing strategies for eradication of the virus from the peripheral reservoirs, it is critical that we pay close attention to the virus in the brain and develop strategies for maintaining it in a latent state failure of which could result in dire consequences.

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