HIV pharmacology: barriers to the eradication of HIV from the CNS.
Total eradication of HIV-1 is not yet achievable, in part because reservoirs of latent HIV-1 can develop within lymphoid tissue, the testes, and the central nervous system (CNS). The presence of HIV-1 in the CNS is clinically significant because of its association with the development of HIV dementia, which occurs in up to one fifth of untreated patients. This review summarizes current theory regarding HIV-1 infection within the CNS, describes physiologic and pharmacologic factors limiting CNS penetration of antiretroviral drugs used to treat HIV-1 infection, and reviews current treatment of CNS HIV-1 infection and HIV encephalopathy.
McGee
Bryan
B
Drug Research Unit, University of California-San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143, USA.
Smith
Nathalie
N
Aweeka
Francesca
F
D015526:AIDS Dementia Complex / Q000188:drug therapy; D000818:Animals; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001812:Blood-Brain Barrier / Q000187:drug effects / Q000821:virology; D015496:CD4-Positive T-Lymphocytes / Q000821:virology; D002490:Central Nervous System / Q000098:blood supply / Q000821:virology; D020805:Central Nervous System Viral Diseases / Q000188:drug therapy* / Q000821:virology*; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D008264:Macrophages / Q000821:virology; D009000:Monocytes / Q000821:virology; D017735:Virus Latency
D019380:Anti-HIV Agents