Cellular and Molecular Neurobiology

, Volume 25, Issue 1, pp 181-199

First online:

Mechanisms of the Blood–Brain Barrier Disruption in HIV-1 Infection

  • Michal ToborekAffiliated withDepartment of Surgery, University of KentuckyDepartment of Surgery, Division of Neurosurgery, University of Kentucky Medical Center Email author 
  • , Yong Woo LeeAffiliated withDepartment of Surgery, University of Kentucky
  • , Govinder FloraAffiliated withDepartment of Surgery, University of Kentucky
  • , Hong PuAffiliated withDepartment of Surgery, University of Kentucky
  • , Ibolya E. AndrásAffiliated withDepartment of Surgery, University of Kentucky
  • , Edward WylegalaAffiliated withDepartment of Ophthalmology, Railway Hospital
  • , Bernhard HennigAffiliated withCollege of Agriculture, University of Kentucky
  • , Avindra NathAffiliated withDepartment of Neurology, Johns Hopkins University

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1. Alterations of brain microvasculature and the disruption of the blood–brain barrier (BBB) integrity are commonly associated with human immunodeficiency virus type 1 (HIV-1) infection. These changes are most frequently found in human immunodeficiency virus-related encephalitis (HIVE) and in human immunodeficiency virus-associated dementia (HAD).

2. It has been hypothesized that the disruption of the BBB occurs early in the course of HIV-1 infection and can be responsible for HIV-1 entry into the CNS.

3. The current review discusses the mechanisms of injury to brain endothelial cells and alterations of the BBB integrity in HIV-infection with focus on the vascular effects of HIV Tat protein. In addition, this review describes the mechanisms of the BBB disruption due to HIV-1 or Tat protein interaction with selected risk factors for HIV infection, such as substance abuse and aging.

Key words

HIV AIDS blood–brain barrier brain endothelial cells inflammatory responses tight junction Tat