MINI REVIEW article
Front. Immunol.
Sec. Viral Immunology
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1650852
This article is part of the Research TopicHIV and the Gut: Novel Insights into HIV Pathogenesis, Clinical Implications and Therapeutic ApproachesView all 7 articles
HIV and the Gut: Implications for HIV persistence, Immune Dysfunction and Cure Strategies
Provisionally accepted
- 1Department of Infectious Diseases, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- 2Victorian Infectious Diseases Service, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- 3Monash Infectious Diseases, Monash Health, Clayton, Australia
- 4Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia
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The intestinal immune compartment plays a central role in HIV pathogenesis, serving as an early site for viral replication and a significant reservoir for latent infection. Despite the success of antiretroviral therapy (ART) in suppressing plasma viremia, HIV persists indefinitely in latently infected cells, commonly found in the intestinal tract due to its unique immunological and structural environment. Targeting HIV-infected cells that persist in the intestinal tract is an important consideration for therapeutic strategies and is also important when considering an HIV cure. This review describes the therapeutic approaches aimed at addressing HIV persistence in the intestinal tract, or gut. We provide a brief overview of mechanisms underlying reservoir formation and maintenance, discuss the challenges posed by gut-specific factors, and examine emerging strategies, including latency reversal agents, immune modulation, gut-targeted ART, and novel delivery systems. This review will focus on contemporary advances in knowledge in this space, gaps in the literature and areas for future research focus.
Keywords: HIV reservoir, Gut-associated lymphoid tissue (GALT), HIV persistence, mucosal immunity, Latency reversal, gene and cell therapies, HIV cure strategies, Antiretroviral penetration
Received: 20 Jun 2025; Accepted: 03 Sep 2025.
Copyright: © 2025 Lau, Lewin and Telwatte. 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: Sushama Telwatte, Department of Infectious Diseases, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
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