HIV and the gut: implications for HIV persistence, immune dysfunction and cure strategies

The intestinal immune compartment plays a central role in HIV pathogenesis, serving as an early site for viral replication and a significant reservoir for latent infection. Despite the success of antiretroviral therapy (ART) in suppressing plasma viremia, HIV persists indefinitely in latently infect...

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Published in:Frontiers in immunology Vol. 16; p. 1650852
Main Authors: Lau, Jillian S. Y., Lewin, Sharon R., Telwatte, Sushama
Format: Journal Article
Language:English
Published: Switzerland Frontiers Media S.A 2025
Subjects:
Animals
Anti-HIV Agents - therapeutic use
Gastrointestinal Microbiome - immunology
gene and cell therapies
gut-associated lymphoid tissue (GALT)
HIV Infections - drug therapy
HIV Infections - immunology
HIV Infections - virology
HIV persistence
HIV reservoir
HIV-1 - immunology
HIV-1 - physiology
Humans
Intestinal Mucosa - immunology
Intestinal Mucosa - virology
latency reversal
mucosal immunity
Virus Latency - drug effects
Virus Latency - immunology
antiretroviral penetration
gut-associated lymphoid tissue (GALT)
HIV cure strategies
latency reversal
HIV persistence
gene and cell therapies
HIV reservoir
mucosal immunity
ISSN:1664-3224, 1664-3224
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Abstract The intestinal immune compartment plays a central role in HIV pathogenesis, serving as an early site for viral replication and a significant reservoir for latent infection. Despite the success of antiretroviral therapy (ART) in suppressing plasma viremia, HIV persists indefinitely in latently infected cells, commonly found in the intestinal tract due to its unique immunological and structural environment. Targeting HIV-infected cells that persist in the intestinal tract is an important consideration for therapeutic strategies and is also important when considering an HIV cure. This review describes the therapeutic approaches aimed at addressing HIV persistence in the intestinal tract, or gut. We provide a brief overview of mechanisms underlying reservoir formation and maintenance, discuss the challenges posed by gut-specific factors, and examine emerging strategies, including latency reversal agents, immune modulation, gut-targeted ART, and novel delivery systems. This review will focus on contemporary advances in knowledge in this space, gaps in the literature and areas for future research focus.
AbstractList The intestinal immune compartment plays a central role in HIV pathogenesis, serving as an early site for viral replication and a significant reservoir for latent infection. Despite the success of antiretroviral therapy (ART) in suppressing plasma viremia, HIV persists indefinitely in latently infected cells, commonly found in the intestinal tract due to its unique immunological and structural environment. Targeting HIV-infected cells that persist in the intestinal tract is an important consideration for therapeutic strategies and is also important when considering an HIV cure. This review describes the therapeutic approaches aimed at addressing HIV persistence in the intestinal tract, or gut. We provide a brief overview of mechanisms underlying reservoir formation and maintenance, discuss the challenges posed by gut-specific factors, and examine emerging strategies, including latency reversal agents, immune modulation, gut-targeted ART, and novel delivery systems. This review will focus on contemporary advances in knowledge in this space, gaps in the literature and areas for future research focus.
The intestinal immune compartment plays a central role in HIV pathogenesis, serving as an early site for viral replication and a significant reservoir for latent infection. Despite the success of antiretroviral therapy (ART) in suppressing plasma viremia, HIV persists indefinitely in latently infected cells, commonly found in the intestinal tract due to its unique immunological and structural environment. Targeting HIV-infected cells that persist in the intestinal tract is an important consideration for therapeutic strategies and is also important when considering an HIV cure. This review describes the therapeutic approaches aimed at addressing HIV persistence in the intestinal tract, or gut. We provide a brief overview of mechanisms underlying reservoir formation and maintenance, discuss the challenges posed by gut-specific factors, and examine emerging strategies, including latency reversal agents, immune modulation, gut-targeted ART, and novel delivery systems. This review will focus on contemporary advances in knowledge in this space, gaps in the literature and areas for future research focus.The intestinal immune compartment plays a central role in HIV pathogenesis, serving as an early site for viral replication and a significant reservoir for latent infection. Despite the success of antiretroviral therapy (ART) in suppressing plasma viremia, HIV persists indefinitely in latently infected cells, commonly found in the intestinal tract due to its unique immunological and structural environment. Targeting HIV-infected cells that persist in the intestinal tract is an important consideration for therapeutic strategies and is also important when considering an HIV cure. This review describes the therapeutic approaches aimed at addressing HIV persistence in the intestinal tract, or gut. We provide a brief overview of mechanisms underlying reservoir formation and maintenance, discuss the challenges posed by gut-specific factors, and examine emerging strategies, including latency reversal agents, immune modulation, gut-targeted ART, and novel delivery systems. This review will focus on contemporary advances in knowledge in this space, gaps in the literature and areas for future research focus.
Author Lau, Jillian S. Y.
Lewin, Sharon R.
Telwatte, Sushama
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  givenname: Sushama
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  fullname: Telwatte, Sushama
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Keywords antiretroviral penetration
gut-associated lymphoid tissue (GALT)
HIV cure strategies
latency reversal
HIV persistence
gene and cell therapies
HIV reservoir
mucosal immunity
Language English
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Snippet The intestinal immune compartment plays a central role in HIV pathogenesis, serving as an early site for viral replication and a significant reservoir for...
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SubjectTerms Animals
Anti-HIV Agents - therapeutic use
Gastrointestinal Microbiome - immunology
gene and cell therapies
gut-associated lymphoid tissue (GALT)
HIV Infections - drug therapy
HIV Infections - immunology
HIV Infections - virology
HIV persistence
HIV reservoir
HIV-1 - immunology
HIV-1 - physiology
Humans
Intestinal Mucosa - immunology
Intestinal Mucosa - virology
latency reversal
mucosal immunity
Virus Latency - drug effects
Virus Latency - immunology
Title HIV and the gut: implications for HIV persistence, immune dysfunction and cure strategies
URI https://www.ncbi.nlm.nih.gov/pubmed/41050701
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