{
  "abstract": "HIV persistence within anatomical reservoirs remains the primary barrier to achieving an HIV cure. While antiretroviral therapy effectively suppresses plasma viremia, it does not eliminate integrated proviral genomes that persist in long-lived cellular compartments. The central nervous system (CNS) is a clinically important HIV reservoir, characterized by immune privilege and the persistence of tissue-resident infection despite effective antiretroviral therapy (ART). Evidence from postmortem studies reveals that HIV DNA, RNA, and even intact replication-competent proviruses remain detectable in brain tissue from virally suppressed people with HIV. Evidence derived primarily from in situ approaches and viable-cell studies supports myeloid-lineage reservoirs, particularly microglia and CNS-associated macrophages, as key cellular sources of persistence, while the extent and biological relevance of astrocyte infection remains debated. These reservoirs exhibit transcriptional activity and are associated with chronic neuroinflammation, which may contribute to HIV-associated neurocognitive disorders, despite systemic viral suppression. Here, we synthesize recent findings from autopsy brain studies, including work enabled by major biorepositories, such as the National NeuroHIV Tissue Consortium and rapid-autopsy programs, including the Last Gift, both of which are essential for studying HIV reservoirs in the CNS. We summarize methodologies for detecting and characterizing HIV in brain tissue, highlight heterogeneous patterns of regional distribution and compartmentalization, and review emerging links between CNS persistence and neuroinflammation. We conclude with priorities for harmonized tissue processing, multi-modal single-cell and spatial profiling, and coordinated cross-cohort analyses to clarify the contribution of CNS reservoirs to neuroHIV pathogenesis and systemic rebound.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, United States of America",
    "Department of Pathology, Microbiology, and Immunology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America",
    "The Emmes Company LLC, Rockville, Maryland, United States of America",
    "Dana-Farber Cancer Institute and Harvard Medical School, Boston, Maryland, United States of America",
    "ATRACT Research Centre, School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Victoria, Australia",
    "AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America",
    "Department of Internal Medicine, University of California, San Diego, La Jolla, California, United States of America",
    "Department of Psychiatry, University of California, San Diego, La Jolla, California, United States of America",
    "Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, United States of America",
    "Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America",
    "Department of Neurology, University of California, Los Angeles, Los Angeles, California, United States of America",
    "Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, United States of America"
  ],
  "article_type": "review",
  "arxiv": null,
  "author_total": 18,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Rajnish S. Dave",
      "orcid": "0000-0003-3439-4936"
    },
    {
      "affs": [
        1
      ],
      "name": "Ayo A. Oludipe"
    },
    {
      "affs": [
        2
      ],
      "name": "Elizabeth C. Pasipanodya",
      "orcid": "0000-0001-8142-9498"
    },
    {
      "affs": [
        2
      ],
      "name": "Seth J. Sherman",
      "orcid": "0000-0003-3667-9898"
    },
    {
      "affs": [
        2
      ],
      "name": "Steffanie H Wilson"
    },
    {
      "affs": [
        3
      ],
      "name": "Dana H. Gabuzda",
      "orcid": "0000-0002-4964-5083"
    },
    {
      "affs": [
        4
      ],
      "name": "Melissa J. Churchill",
      "orcid": "0000-0001-5510-7954"
    },
    {
      "affs": [
        4
      ],
      "name": "Thomas A. Angelovich",
      "orcid": "0000-0003-2069-0451"
    },
    {
      "affs": [
        5
      ],
      "name": "Robert J. Gorelick",
      "orcid": "0000-0002-1773-9085"
    },
    {
      "affs": [
        6
      ],
      "name": "Sara Gianella",
      "orcid": "0000-0002-9927-0849"
    },
    {
      "affs": [
        6
      ],
      "name": "Antoine Chaillon",
      "orcid": "0000-0001-9490-3857"
    },
    {
      "affs": [
        7
      ],
      "name": "Jerel Adam Fields",
      "orcid": "0000-0002-8168-1412"
    },
    {
      "affs": [
        8
      ],
      "name": "Susan Morgello",
      "orcid": "0000-0001-7729-245X"
    },
    {
      "affs": [
        9
      ],
      "name": "Benjamin B. Gelman"
    },
    {
      "affs": [
        7
      ],
      "name": "David J. Moore",
      "orcid": "0000-0001-9699-318X"
    },
    {
      "affs": [
        10
      ],
      "name": "Elyse J. Singer",
      "orcid": "0000-0001-9166-6534"
    },
    {
      "affs": [
        11
      ],
      "name": "Beau M. Ances",
      "orcid": "0000-0003-3862-7397"
    },
    {
      "affs": [
        0
      ],
      "name": "Howard S. Fox",
      "orcid": "0000-0003-2032-374X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3hjyckz9m2xkk.bib",
  "cited_by": 6,
  "doi": "10.1371/journal.ppat.1014446",
  "fulltext_url": null,
  "id": "3hjyckz9m2xkk",
  "issns": [
    "1553-7366",
    "1553-7374"
  ],
  "landing_url": "https://doi.org/10.1371/journal.ppat.1014446",
  "language": "en",
  "licence": "PDM-1.0",
  "licence_label": "Public domain",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/publicdomain/mark/1.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2406|HIV Research and Treatment"
    ]
  ],
  "openalex": "W7171693169",
  "pdf_url": "https://journals.plos.org/plospathogens/article/file?id=10.1371/journal.ppat.1014446&type=printable",
  "pmcid": "PMC13419195",
  "pmid": "42525639",
  "published": "2026-07-29",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/3hjyckz9m2xkk.ris",
  "sources": [
    {
      "first_seen": "2026-11-06T13:20:33Z",
      "native_id": "W7171693169",
      "source": "openalex",
      "url": "https://doi.org/10.1371/journal.ppat.1014446"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:2406|HIV Research and Treatment",
      "subfield": "microbiology"
    }
  ],
  "title": "The brain as an HIV reservoir: Recent findings using autopsy tissues from people with HIV",
  "title_text": "The brain as an HIV reservoir: Recent findings using autopsy tissues from people with HIV",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T13:21:09Z",
  "url": "https://research.draconitic.com/paper/3hjyckz9m2xkk",
  "venue": "PLoS Pathogens",
  "versions": []
}