The brain as an HIV reservoir: Recent findings using autopsy tissues from people with HIV.

HIV persists in brain tissues of virally suppressed individuals, with intact proviruses found in microglia and macrophages, challenging the notion of complete viral eradication.

• Why it matters: Understanding the brain as an HIV reservoir is crucial because it may contribute to neurocognitive disorders and systemic rebound despite effective antiretroviral therapy, highlighting a significant barrier to a cure.
• What they did: Autopsy brain tissues from people with HIV were analyzed using in situ and viable-cell approaches, leveraging biorepositories like the National NeuroHIV Tissue Consortium and rapid-autopsy programs to detect HIV DNA, RNA, and replication-competent viruses.
• The result: Findings reveal heterogeneous distribution and ongoing transcriptional activity of HIV in the CNS, emphasizing the need for harmonized tissue analysis and advanced profiling to better understand neuroHIV pathogenesis and improve eradication strategies.