Lentiviral Infections Persist in Brain despite Effective Antiretroviral Therapy and Neuroimmune Activation
Nazanin Mohammadzadeh, Weston Roda, William G. Branton, Julien Clain, Henintsoa Rabezanahary, Ouafa Zghidi-Abouzid, Benjamin B. Gelman, Jonathan B. Angel, Eric A. Cohen, M. John Gill, Michael Li, Jérome Estaquier, Christopher Power
Abstract
Antiretroviral therapy (ART) suppresses HIV-1 in plasma and CSF to undetectable levels. However, the impact of contemporary ART on HIV-1 brain reservoirs remains uncertain. An active viral reservoir in the brain during ART could lead to rebound systemic infection after cessation of therapy, development of drug resistance mutations, and neurological disease. ART's impact, including its interruption, on brain proviral DNA remains unclear. The present studies show that in different experimental platforms, contemporary ART did not suppress viral burden in the brain, regardless of ART component regimen, the duration of therapy, and its interruption. Thus, new strategies for effective HIV-1 suppression in the brain are imperative to achieve sustained HIV suppression.