Neuropathogenesis of HIV-1 infection. Outstanding questions

Significant progress in understanding and treating acquired immunodeficienc y syndrome (AIDS) has been made over the last 5 years. Current multi drug t herapies prolong patients' lives and reduce the incidence of neurobehaviour al symptoms. However, the impact of therapy on human immunodeficiency virus type one (HIV-l), the causative agent of AIDS, in the brain, is unknown. S ome patients develop dementia in spite of the multi drug therapies and othe rs develop subtle neurobehavioural changes that diminish the quality of the ir prolonged lives. Thus, HIV-1 infection of the central nervous system rem ains an important clinical concern. Although much is known about neuropatho logy of HIV-1 infection, major questions about neuropathogenesis remain. Ho w does HIV-1 reach the brain! Is it present in neurons and glial cells? Wha t is the biological and therapeutic significance of neurotropism of HIV-1! What causes neuronal damage and loss? And, is CNS a reservoir of HIV-1! Mor e research in vivo and in situ in humans and in animals, is needed to answe r these outstanding questions. Specific experiments addressing these questi ons are proposed. ((C) Academie des sciences / Elsevier, Paris.).