Microglia in HIV-associated neurological diseases

Human immunodeficiency virus type-1 (HIV-1) is a neurotropic virus linked to a variety of progressive neurologic disorders. This review describes our current understanding of how HIV-1 enters the nervous system and interacts with neuronal and non-neuronal cells to initiate and sustain neurologic dysfunction. The overwhelming majority of cells infected with HIV-1 in the nervous system are microglia/macrophages. Microglial/macrophage infection leads to immune dysregulation as well as production and release of cytotoxic molecules. Interaction of these infected cells with astrocytes may accelerate neurotoxic mechanisms. A hypothetical scenario for how HIV-1 infection leads to neurologic disease is presented.