HIV treatment has transformed the disease from a once-deadly infection into a manageable condition for millions of people. Yet researchers are increasingly focused on a problem that standard treatment does not fully solve: the virus can persist in the brain even when antiretroviral therapy (ART) successfully suppresses viral replication.

Now, Weill Cornell Medicine and Rutgers Health have received a four-year, $3 million grant from the US National Institute of Mental Health to establish the New York-New Jersey Center for Actionable NeuroHIV Biomarkers. The centre will investigate how HIV affects the brain and search for biological markers that could eventually lead to better diagnostics and treatments.

Why Can HIV Persist in the Brain?

ART works by blocking HIV from replicating, dramatically reducing the amount of virus circulating in the body. But treatment does not completely eliminate HIV from every infected cell.

Some infected cells can form what scientists call viral reservoirs, where HIV remains in a dormant or difficult-to-target state. The brain is particularly important because the central nervous system has biological barriers that can make it harder for drugs and immune cells to reach infected cells.

According to Weill Cornell, HIV can persist in reservoirs in the brain even during the era of effective treatment. This persistence may contribute to cognitive and behavioural difficulties, depression, and motor problems.

The issue matters on a global scale. UNAIDS estimates that 41 million people were living with HIV worldwide in 2025, while 32.1 million were receiving ART.

What Happens to the Brain?

Scientists use the term 'neuroHIV' to describe HIV's involvement in the central nervous system.

The virus does not necessarily have to cause widespread destruction of brain cells to affect brain function. Infection and the body's immune response can contribute to inflammation and changes in the environment surrounding neurons and other brain cells.

For some people, these changes may manifest as difficulties with thinking, memory, movement, or mood. The severity can vary considerably, and effective ART has substantially reduced the severe forms of HIV-associated dementia seen before modern treatment became widely available.

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What Will the New Research Centre Do?

The new centre aims to investigate the biological mechanisms behind ongoing brain injury rather than simply documenting its symptoms.

Researchers will have access to molecular and computational tools specifically designed to study neuroHIV. The programme will also use advanced methods for culturing human tissue, including organoids, sometimes described as 'mini brains', to examine how HIV interacts with brain cells.

Another major goal is identifying molecular biomarkers. These could eventually help researchers determine which people with HIV are at greater risk of neurological complications and potentially identify treatments that specifically target brain-related injury.

Could This Lead to Better HIV Treatment?

That is ultimately the hope, but the research is still in its early stages. Current ART remains essential for controlling HIV and protecting health. The new centre is not intended to replace existing treatment.

Instead, scientists want to understand what happens after viral replication has been effectively suppressed and why some neurological problems can persist.

'There are still no effective therapies that specifically prevent or mitigate ongoing brain injury,' said Dr Lishomwa Ndhlovu, co-director of the centre, according to Weill Cornell.

By uncovering how HIV survives in the brain and identifying measurable signs of neurological injury, researchers hope to develop more targeted approaches in the future.

For people living with HIV, the research could eventually address an important gap in modern treatment: controlling the virus may be possible, but understanding and preventing its lingering effects on the brain remains a significant scientific challenge.

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