Immune reconstitution inflammatory syndrome drives emergence of HIV drug resistance from multiple anatomic compartments in a person living with HIV.
case_report · Level V
Where this comes from
- Record sourced from PubMed, PMID 37322122.
- Also identified by DOI 10.1038/s41591-023-02387-4 and PMC identifier 10494392.
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Abstract
Reservoirs of HIV maintained in anatomic compartments during antiretroviral therapy prevent HIV eradication. However, mechanisms driving their persistence and interventions to control them remain elusive. Here we report the presence of an inducible HIV reservoir within antigen-specific CD4<sup>+</sup>T cells in the central nervous system of a 59-year-old male with progressive multifocal leukoencephalopathy immune reconstitution inflammatory syndrome (PML-IRIS). HIV production during PML-IRIS was suppressed by modulating inflammation with corticosteroids; selection of HIV drug resistance caused subsequent breakthrough viremia. Therefore, inflammation can influence the composition, distribution and induction of HIV reservoirs, warranting it as a key consideration for developing effective HIV remission strategies.
Medical subject headings
- Immune Reconstitution Inflammatory Syndrome
- Leukoencephalopathy, Progressive Multifocal
- HIV Infections