Chapter 12- Brain as an HIV sequestered site: Use of nanoparticles as a therapeutic option.

Patients infected with human immunodeficiency virus (HIV) are at increased risk to develop neurocognitive problems. HIV crosses the blood-brain barrier (BBB) through a variety of means. Once within the brain tissue, HIV stimulates immunoactivation and inflammation that lead to neuronal loss. This review discusses the pathophysiology of HIV within the brain and the treatment modalities used to prevent neurocognitive problems from developing. Modalities that prevent antiretroviral drugs from crossing into the central nervous system and reducing viral load are also discussed. Finally, since drug penetration across the BBB is reduced, the use of nanoparticles as a treatment modality to increase BBB penetration may be an option worth further exploration. Copyright 2009 Elsevier B.V. All rights reserved.