The growth and the control of human immunodeficiency virus in the lung: implications for highly active antiretroviral therapy

In recent years, it has become apparent that the lung is an important niche for the proliferation of human immunodeficiency virus (HIV), which may hav e implications for highly active antiretroviral therapy (HAART). The lung i tself is a major site for the opportunistic infections associated with the progression to acquired immune deficiency syndrome (AIDS), specifically Pne umocystis carinii, Myobacterium tuberculosis and pyogenic bacteria. These c ases of active pulmonary complications are direct indicators of enhanced pr ogression to AIDS-defining illness and increased morbidity and mortality. I t is therefore essential that the interaction between the lung and HIV is f ully understood. Recent research indicates the lung may be a major sanctuar y for the virus, with distinct evolution and replication in contrast to oth er target organs for HIV. In this review, we will discuss the recent findin gs of HIV infection, evolution, host factors involved in the control of HIV within the lung and the impact this may have on current therapy.