Influence of mitochondrial control of apoptosis on the pathogenesis, complications and treatment of HIV infection

HIV infection is inexorably linked with disordered regulation of apoptosis, and consequent alterations in mitochondrial homeostasis, resulting in CD4 T cell death and enhanced susceptibility to opportunistic infections and malignancies. Effective treatment of HIV reverses the changes in mitochondrial homeostasis and apoptosis, and enhances immunocompetence. This review will summarize current knowledge of: i) the associations of apoptosis with HIV disease progression; ii) mechanisms of enhanced apoptosis in HIV infection; iii) putative role of apoptosis in HIV complications; iv) direct effects of HIV therapies on mitochondria and apoptosis; and finally v) treatment strategies for HIV based upon modifying the apoptotic response.