mGem: Innate immune sensing of HIV-1 transcription in myeloid cells—a tale of two transcription start sites

Suppressive antiretroviral therapy (ART) in people with HIV (PWH) arrests progression to AIDS and onward viral transmission. However, viral transcription from integrated HIV-1 proviruses persists on treatment and is linked to markers of chronic immune activation, contributing to the accelerated development of comorbidities in PWH. Of particular interest are persistent responses in long-lived tissue-resident myeloid cells, which direct tissue-level inflammatory processes through cytokine secretion and interactions with other immune cell populations. Here, we review recent findings on viral nucleic acid sensing events in HIV-infected myeloid cells to shed light on possible mechanisms of persistent inflammation resulting from chronic HIV-1 transcription in myeloid cells in PWH.