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REVIEW article

Front. Immunol.

Sec. Viral Immunology

Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1621338

This article is part of the Research TopicHIV-1 Tat, An Enhancer of Virus Infectivity and Disease Promoter: Target for Preventive and Therapeutic InterventionsView all 6 articles

HIV-Tat and Vascular Endothelium: Implications in the HIV associated Brain, Heart, and Lung complications

Provisionally accepted
  • University of Kansas Medical Center, Kansas City, United States

The final, formatted version of the article will be published soon.

Following the advent of antiretroviral therapy (ART), neurological, cardiovascular, and pulmonary comorbidities emerged as major challenges in treating non-infectious complications in people living with HIV. Despite effective ART, HIV viral proteins can persist in circulation even in individuals with negligible viral loads, potentially contributing to cellular and tissue-level stress, inflammation, and related health complications. Most of the HIV protein: Tat (Trans activator of Transcription), expressed in HIV-infected cells, is actively secreted and exerts its pathological effects on non-infected cells, particularly impacting the vascular endothelium. This review focuses on the role and the underlying mechanisms of HIV-Tat in promoting endothelial dysfunction across the cardiovascular, pulmonary, and brain vasculature. Additionally, we discuss how HIV-Tat interacts synergistically with drugs of abuse to exacerbate endothelial damage. Importantly, the vascular damage caused by Tat is not fully mitigated by HAART, necessitating further mechanistic investigations and targeted therapeutic interventions. Additionally, cessation of drug abuse is indispensable for improving clinical outcomes and restoring vascular health in people living with HIV.

Keywords: Endothelium, Tat, blood brain barrier, Pulmonary vascular remodeling, Cardiovascular dysfunction

Received: 12 May 2025; Accepted: 21 Jul 2025.

Copyright: © 2025 Chandran, Chen, Kaur and Dhillon. 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) or licensor 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: Navneet Kaur Dhillon, University of Kansas Medical Center, Kansas City, United States

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