Mononuclear phagocyte immunity and the neuropathogenesis of HIV-1 infection

Yuri Persidsky, Howard E. Gendelman

Research output: Contribution to journalArticlepeer-review

147 Scopus citations


Human immunodeficiency virus type 1 (HIV-1)-associated dementia is a neuroinflammatory brain disorder that is fueled by viral infection and immune activation of brain mononuclear phagocytes (MP; macrophages and microglia). MP serve as a reservoir for persistent viral infection, a vehicle for viral dissemination throughout the brain, and a major source of neurotoxic products that when produced in abundance, affect neuronal function. Such neurotoxic substances secreted by MP lead to clinical neurological impairment (cognitive, behavior, and motor abnormalities), which occurs usually years after the initial viral infection. How HIV-1 evades the immune function characteristic for MP as a first line of defense, including phagocytosis and intracellular killing, is not well understood despite more than two decades of study. In this report, we review the complex role(s) played by MP in the neuropathogenesis of HIV-1 infection. The clinical manifestations, pathology and pathogenesis, and treatment options are discussed in relationship to innate and adaptive immunity. Particular emphasis is given to the diversity of MP functions and how it may affect the disease process and manifestations. New insights into disease mechanisms are provided by advances in enhanced magnetic resonance imaging and proteomics to identify cell movement and genetic profiles of disease. New therapeutic strategies are discussed based on current knowledge of HIV-1-associated dementia pathogenesis.

Original languageEnglish (US)
Pages (from-to)691-701
Number of pages11
JournalJournal of Leukocyte Biology
Issue number5
StatePublished - Nov 2003


  • Animal model
  • Blood-brain barrier
  • HIV-1 encephalitis
  • Neuronal damage

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Cell Biology


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