Blood-brain barrier and neuro-AIDS

Neuro-AIDS is becoming a major health problem among AIDS patients who experience improved survival under combined antiretroviral therapy (cART). Neuronal injury and loss are the critical issues of neuro-AIDS that need the entry of HIV into the central nervous system (CNS) via peripheral infected monocyte/macrophage carriers or viral direct penetration of blood-brain barrier (BBB). The mechanisms of HIV enhancing BBB permeability and entering CNS and the effect of drug abuse in HIV traffic across BBB are discussed. In addition, the current anti-HIV drugs, although they are effective in reducing plasma viral level, cannot eradicate the viruses completely from CNS. The possible mechanism of BBB hindrance and anti-HIV drug efflux by transport proteins, and general methods used to deliver antiretroviral drugs into brain are also discussed.