Fig. 4
From: Potential molecular mechanisms of chronic fatigue in long haul COVID and other viral diseases
Chronic HIV infection in neuroinflammation and demyelination. HIV directly infects CD4 + T lymphocytes (#1). Infected T cells interact with macrophages causing the production of inflammatory cytokines (IL-1β, TNFα, IL6, and IL12), chemokines (CCL2. Rantes, CXCL12), reactive oxygen species (ROS), and nitric oxide. These factors together contribute to the death of Schwan cells and therefore cause peripheral demyelination (#2). HIV virions and surface protein gp120 also contribute to CNS pathology by direct interaction with microglia (#3). Subsequent production of inflammatory molecules directly causes the death of oligodendrocytes (#4) (abbreviated as “oligos”) followed by demyelination and neurodegeneration