Show Summary Details
Page of

Viral Dynamics 

Viral Dynamics
Viral Dynamics

Davey M. Smith

and Ronald J. Ellis

Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2020. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 07 July 2020

The central nervous system (CNS) possesses specific physiologic and anatomic characteristics that can contribute to the genetic evolution of HIV both in the CNS and systemically. The CNS can function as a reservoir, a compartment, and a drug sanctuary. A viral "reservoir" harbors replication-competent virus, making it possible for the virus to re-emerge after a period of suppression. A viral "compartment" refers to a situation wherein viral movement is restricted between anatomic sites or tissues, such as between the brain and blood. In the CNS, this restricted movement can ultimately lead to a divergence of genetic sequences between compartments. A "drug sanctuary" refers to a restriction of access of medication. As a drug sanctuary, the CNS can create an environment that facilitates additional genetic divergence between the viral populations in blood and CNS. These divergences can have clinical consequences in terms of the selection for antiretroviral resistance. This chapter reviews the evidence and clinical consequences of HIV-1 evolution and dynamics associated with the specialized tissues of the CNS.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.