HIV Compartmentalization in Male Genital Tract: Relevance for Viral Eradication

Abstract Human immunodeficiency virus (HIV) has been shown to evolve independently in different anatomical compartments. Characterizing HIV genetic evolution in different tissues and cells provides insights into the mechanisms that maintain the viral reservoir. HIV compartmentalization has been well documented in the semen but rarely in male genital tract (MGT) organs. The precise mechanisms that result in the development of HIV compartmentalization in multiple genitourinary sites have been poorly explored due to the difficulty in accessing these tissues. Based on evidence from lymph nodes and gut tissues, mechanisms that may influence compartmentalization include immune pressures, local concentrations of antiviral drugs, clonal expansion of different cell types and inflammation that alters the cellular microenvironment. We reviewed phylogenetic evidences supporting viral compartmentalization between the blood and multiple genitourinary sites in HIV-infected people. Characterizing distinct viral sub-populations enhances our overall understanding of the HIV reservoir in MGT and could ultimately lead to the development of novel therapies to eradicate the virus in tissues.