STAT1-Mediated Regulation of IL-17A/CEBPB/NF-κB Axisin HIV-1 Infected Human Cerebral Organoids RevealsTherapeutic Targets for Neuroprotection

HIV-associated neurological complications remain a major concern in people living with HIV (PLWH), even under effective viral suppression with combination antiretroviral therapy (cART), underscoring unresolved mechanisms driving HIV-related neurodegeneration. To address this gap, we used HIV-1-infected human cerebral organoids (hCOs) containing microglia as a physiologically relevant three-dimensional model of the central nervous system (CNS) and validated key findings in simian immunodeficiency virus (SIV)-infected, cART-treated rhesus macaque model. Integrating single-nucleus RNA sequencing with ATAC sequencing, we identified cell-type-specific alterations in dual innate immune-driven inflammatory signaling pathways across neural and glial populations. Microglia were preferentially infected and activated, initiating IL-17A-mediated cascades involving IFN-{gamma}/STAT1, CEBPB, and NF-{kappa}B pathways, which converged with cGAS-STING and Notch-NEURL1 signaling, both associated with neuroinflammation and synaptic dysfunction. cART suppressed viral replication, reduced IL-17A-driven neuroinflammation, improved mitochondrial function, and restored synaptic gene expression. Collectively, these findings identify IL-17A, STAT1, CEBPB, and cGAS-STING as key molecular drivers of HIV-associated neuroinflammation and establish a novel mechanistic link between IL-17A signaling and microglial remodeling, providing a translational framework for the development of CNS-targeted therapies in PLWH.