Beyond Silos: A Comprehensive Understanding of HIV Functional Cure and NeuroHIV

Dear Colleagues,

This Special Issue of IJMS is dedicated to advancing the battle against HIV. While combination antiretroviral therapy (cART) has considerably improved the lives of people living with HIV, significant challenges persist, including side effects, the risk of drug resistance, and the combined physical and financial burden of lifelong treatment. Central to these challenges is the reservoir of latently infected cells that endure even under cART treatment. These reservoirs, primarily located in secondary lymphoid tissues, form a very early acute phase of virus infection and cause a recurrence of viremia upon cART cessation. A particularly concerning development is brain infiltration, leading to HIV-associated neurocognitive disorders. This condition covers a spectrum of symptoms, from cognitive disturbances to motor dysfunctions and behavioral shifts. Microglia and astrocytes can harbor the virus within the brain, allowing it to remain even when ART is administered.

While many antivirals aim at viral enzymes, there is growing interest in those tackling virus disassembly and maturation. Importantly, capsid inhibition, a novel mechanism of action, holds promise and is being studied for long-acting treatments to improve patient adherence. As the ability of an antiretroviral drug to cross the blood–brain barrier (BBB) is crucial for effectively treating HIV, if the new drugs can effectively access and counteract HIV in these brain reservoirs, it could mark a significant leap towards a more potent treatment or even a potential cure for HIV.

In this Special Issue, we welcome authors spanning a vast range, from understanding HIV latency and NeuroHIV pioneering methods of reservoir detection, host–virus dynamics, and the evolution of novel antivirals. Our ultimate goal in this topic is to understand groundbreaking HIV treatments and remission tactics comprehensively.

Dr. Taisuke Izumi
Dr. Alexander Zestos
Prof. Dr. Anthony L. Riley
Guest Editors

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• neuroHIV
• functional cure
• antiretroviral therapy
• reservoir
• long-acting antivirals
• chronic infection
• host–virus interactions
• immunotherapy
• persistence
• remission