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total viral erradication.
Feb 7, 2005

I've been HIV+ for two years and fortunately I'm very healthy and don't need to take meds yet. I'm doing all I can through diet and exercise to increase the time before I need to take meds. My question is about viral reservoirs. I understand that some drugs to activate the latent memory Tcell line are in early stages of development and that other reservoirs (in the presnece of HAART) may simply die out because of the half life of the cells involved. I'm confused however as to the impact that HIV and the brain/nerve cells will have on this field of research. I understand that nerve cells don't actually divide and therefore may not be affected by and new drugs that come along. There is also the issue of the blood brain barrier. Some newer news reports and websites are now reporting that HIV doesn't actually infect nerve cells directly. My question is: Is this the case, does HIV infect nerve/brain cells or not?

Response from Dr. Pierone

HIV is able to cross the blood brain barrier and the most likely mechanism is by hiding out in "Trojan Horse" cells of monocyte origin. These cells differentiate into microglial cells in the central nervous system (CNS) and serve as the primary immune cells there. Microglial cells support HIV replication, while neurons and oligodendrocytes do not. Astrocytes comprise the most numerous cell type in the CNS and are able to be infected with HIV, but are not able to support ongoing viral replication this phenomenon is called restricted infection. So the long answer to your question is that HIV does infect some nerve brain cells, but not all.

So what is the implication of these CNS findings on potential therapies for HIV infection? If an agent is aimed at activating (and thus purging) viral reservoirs, it had better have blood brain penetration as a prime attribute, so that the microglial cells get invited to the party.

In any case, this is all speculative since "purging" of HIV infected cells is not on the immediate horizon, but is a very interesting idea. Thanks for posting and stay tuned!



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