HIV attacks the body’s immune cells, frequently compromises the integrity of the blood–brain barrier (BBB), and infects the CNS in the early stages of infection. Dysfunction of the BBB further potentiates viral replication within the CNS, which can lead to HIV-associated neuropathology. Antiretroviral therapy (ART) significantly improves HIV patient outcomes and reduces mortality rates. However, there has been limited progress in targeting latent viral reservoirs within the CNS, which may eventually lead to rebound viremia. While ART drugs are shown to be effective in attenuating HIV replication in the periphery, the protection of the brain by the BBB offers an isolated sanctuary to harbor HIV and maintains chronic and persistent replication within the CNS. In this review, we elucidate the pathology of the BBB, its ability to potentiate viral replication, as well as current therapies and insufficiencies in treating HIV-infected individuals.

中文翻译：

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HIV 血脑屏障渗透和抗逆转录病毒药物递送缺陷的悖论

HIV 攻击人体的免疫细胞，经常破坏血脑屏障 (BBB) 的完整性，并在感染的早期阶段感染中枢神经系统。BBB 的功能障碍进一步加强了 CNS 内的病毒复制，这可能导致 HIV 相关的神经病理学。抗逆转录病毒疗法 (ART) 可显着改善 HIV 患者的预后并降低死亡率。然而，在靶向 CNS 内的潜伏病毒库方面进展有限，这可能最终导致病毒血症反弹。虽然 ART 药物被证明可有效减弱外周的 HIV 复制，但 BBB 对大脑的保护提供了一个孤立的避难所来藏匿 HIV 并维持 CNS 内的慢性和持续复制。在这篇综述中，我们阐明了 BBB 的病理学，