Coreceptor usage in different reservoirs.

PURPOSE OF REVIEW: HIV-1 infects tissue macrophages, microglia and other mononuclear phagocytes which represent an important cellular reservoir for viral replication and persistence in macrophage-rich tissue. This compartmentalization allows the virus to exist as genetically distinct quasi-species that can have capacities to use different coreceptors for cell entry. This review assesses the tropism of HIV-1 in different human compartments. RECENT
FINDINGS: The majority of HIV infection occurs with R5-tropic viruses probably due to the selective expression of the R5 cell-surface protein on the target cells in the genital muscosa. There is a large concordance of tropism use between blood cell-associated proviral DNA and RNA plasma viruses, allowing the use of CC chemokine receptor 5 (CCR5) antagonists in patients who have undetectable viral load and for whom HIV tropism was determined in DNA. Most of HIV strains in central nervous system remain R5-tropic allowing the use of CCR5 antagonists.
SUMMARY: There are many clinical situations in which the use of CCR5 antagonists can be used and several ways to determine HIV tropism in most of the compartments.