Human Immunodeficiency Virus Persistence in the Spleen: Opportunities for Pharmacologic Intervention

AIDS Res Hum Retroviruses. 2021 Oct;37(10):725-735. doi: 10.1089/AID.2020.0266. Epub 2021 Feb 22.


The persistence of HIV in the spleen, despite combination antiretroviral therapy, is not well understood. Sustained immune dysregulation and delayed immune recovery, in addition to immune cell exhaustion, may contribute to persistence of infection in the spleen. Eliminating HIV from this secondary lymphoid organ will require a thorough understanding of antiretroviral (ARV) pharmacology in the spleen, which has been minimally investigated. Low ARV exposure within the spleen may hinder the achievement of a functional or sterilizing cure if cells are not protected from HIV infection. In this study, we provide an overview of the anatomy and physiology of the spleen, review the evidence of the spleen as a site for persistence of HIV, discuss the consequences of persistence of HIV in the spleen, address challenges to eradicating HIV in the spleen, and examine opportunities for future curative efforts.

Keywords: HIV; antiretrovirals; persistence; pharmacology; reservoirs; spleen.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-Retroviral Agents / therapeutic use
  • HIV
  • HIV Infections* / drug therapy
  • Humans
  • Spleen
  • Virus Latency


  • Anti-Retroviral Agents