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2016 ; 11
(4
): 362-70
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Tissue reservoirs of HIV
#MMPMID27259045
Wong JK
; Yukl SA
Curr Opin HIV AIDS
2016[Jul]; 11
(4
): 362-70
PMID27259045
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PURPOSE OF REVIEW: Tissue reservoirs of HIV may promote the persistent
immunopathology responsible for non-AIDS morbidity and data support multifocal
reactivation from tissues as the source of viral rebound during antiretroviral
therapy (ART) interruption. The heterogeneity of tissue reservoirs and incomplete
knowledge about their composition are obstacles to an HIV cure. RECENT FINDINGS:
In addition to the higher concentration of infected CD4 T cells found in both
central lymphoid tissues and gut, specific subsets of CD4 T cells appear to play
a disproportionate role in HIV persistence. Recently, a subset of central memory
T cells enriched in lymph node germinal centers called T-follicular helper cells
has been identified that expresses more viral RNA and occupies an anatomic niche
inaccessible to cytotoxic T lymphocyte killing. Additional observations suggest
that antiretroviral drug (ARV) concentrations may be lower in some tissues,
raising the possibility for localized, low-level viral replication. Finally, some
recent data implicate the persistence of infected, non-CD4 T-cell types in
tissues during ART. SUMMARY: The retention of infected cells in a wide variety of
tissues, often with distinct viral and cellular characteristics, underscores the
importance of studying tissue reservoirs in the development and assessment of
cure strategies. Both inhibitory ARVs and latency-reversing drugs must reach
these sites, and novel strategies may be needed to attack virus in cells as
variable as T-follicular helper cells and macrophages.
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