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Front. Immunol. | doi: 10.3389/fimmu.2019.02077

Seeing is Believing: Nuclear Imaging of HIV Persistence

 Timothy J. Henrich1*, Priscilla Y. Hsue2 and  Henry VanBrocklin1
  • 1University of California, San Francisco, United States
  • 2Department of Medicine, University of California, San Francisco, United States

A major obstacle to HIV eradication is the presence of infected cells that persist despite suppressive antiretroviral therapy (ART). HIV largely resides outside of the peripheral circulation, and thus, numerous anatomical and lymphoid compartments that have the capacity to harbor HIV are inaccessible to routine sampling. As a result, there is a limited understanding of the tissue burden of HIV infection or anatomical distribution of HIV transcriptional and translational activity. Novel, non-invasive, in vivo methods are urgently needed to address this fundamental gap in knowledge. In this review, we discuss past and current nuclear imaging approaches that have been applied to HIV infection with an emphasis on current strategies to implement positron emission tomography (PET) based imaging to directly visualize and characterize whole-body HIV burden. These imaging approaches have various limitations, such as the potential for limited PET sensitivity and specificity in the setting of ART suppression or low viral burden. However, recent advances in high-sensitivity, total-body PET imaging platforms and development of new radiotracer technologies that may enhance anatomical penetration of target-specific tracer molecules are discussed. Potential strategies to image non-viral markers of HIV tissue burden or focal immune perturbation are also addressed. Overall, emerging nuclear imaging techniques and platforms may play an important role in the development of novel therapeutic and HIV reservoir eradication strategies.

Keywords: human immunodeficiency virus - HIV, positron emission tomography – PET, Simian Immunodeficiency Virus (SIV), Nuclear Medicine, Molecular Imaging

Received: 13 Jun 2019; Accepted: 16 Aug 2019.

Copyright: © 2019 Henrich, Hsue and VanBrocklin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Timothy J. Henrich, University of California, San Francisco, San Francisco, United States, timothy.henrich@ucsf.edu