Is the central nervous system a reservoir of HIV-1?

Gray, L, Roche, M, Flynn, J, Wesselingh, S, Gorry, P and Churchill, M 2014, 'Is the central nervous system a reservoir of HIV-1?', Current Opinion in HIV and AIDS, vol. 9, no. 6, pp. 552-558.

Document type: Journal Article
Collection: Journal Articles

Title Is the central nervous system a reservoir of HIV-1?
Author(s) Gray, L
Roche, M
Flynn, J
Wesselingh, S
Gorry, P
Churchill, M
Year 2014
Journal name Current Opinion in HIV and AIDS
Volume number 9
Issue number 6
Start page 552
End page 558
Total pages 7
Publisher Wolters Kluwer
Abstract Purpose of review: To summarize the evidence in the literature that supports the central nervous system (CNS) as a viral reservoir for HIV-1 and to prioritize future research efforts. Recent findings: HIV-1 DNA has been detected in brain tissue of patients with undetectable viral load or neurocognitive disorders, and is associated with long-lived cells such as astrocytes and microglia. In neurocognitively normal patients, HIV-1 can be found at high frequency in these cells (4% of astrocytes and 20% of macrophages). CNS cells have unique molecular mechanisms to suppress viral replication and induce latency, which include increased expression of dominant negative transcription factors and suppressive epigenetic factors. There is also evidence of continued inflammation in patients lacking a CNS viral load, suggesting the production and activity of viral neurotoxins (for example, Tat). Summary: Together, these findings provide evidence that the CNS can potentially act as a viral reservoir of HIV-1. However, the majority of these studies were performed in historical cohorts (absence of combination antiretroviral therapy or presence of viral load), which do not reflect modern day patients (combination antiretroviral therapy-treated and undetectable viral load). Future studies will need to examine patient samples with these characteristics to conclusively determine whether the CNS represents a relevant and important viral reservoir.
Subject Infectious Diseases
Keyword(s) central nervous system
DOI - identifier 10.1097/COH.0000000000000108
Copyright notice © 2014 Lippincott Williams & Wilkins, Inc.
ISSN 1746-630X
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Citation counts: TR Web of Science Citation Count  Cited 57 times in Thomson Reuters Web of Science Article | Citations
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