A review on HIV Blood-Brain Barrier Penetrance and Antiretroviral Drug Delivery Deficiencies: A Paradox Revisited

Abstract

HIV has the ability to infect immune cells that can migrate into the brain by crossing the blood-brain barrier. As a result, HIV can disguise itself to evade this biological barrier, which typically restricts the entry of most foreign substances. The majority of antiretroviral drugs are either unable to effectively penetrate the blood-brain barrier or are efficiently eliminated from the brain tissue. Consequently, this leads to the ineffective elimination of HIV from the brain and the formation of reservoirs. Within the brain, there exist diverse cell reservoirs that can harbor dormant HIV. This accumulation within the central nervous system (CNS) can result in viral recurrence and rebound infection. The brain-targeting efficiency of clinically administered antiretroviral drugs is generally low. However, the utilization of nano-formulations of these drugs holds the potential to enhance the bioavailability of effective medications in specific regions while preserving neurological integrity.