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The HIV-1 Trans-Activator of Transcription (Tat) protein is a small, multifunctional regulatory protein encoded by the tat gene in the HIV-1 genome[2][3]. Tat is essential for efficient HIV-1 replication as it dramatically increases the efficiency of viral transcription by binding to the TAR (trans-activation response) RNA element at the 5' end of viral mRNA and recruiting cellular cofactors such as Cyclin T1 and CDK9, forming the P-TEFb complex that phosphorylates RNA polymerase II to enhance transcription elongation[1][2][3]. Tat also modulates cellular gene expression, impacts the immune response, is released extracellularly from infected cells, and contributes to HIV pathology by inducing apoptosis in uninfected bystander cells and playing a role in development of HIV-associated neurocognitive disorders[1][2][3]. Tat is a canonical example of a viral transcription factor that interacts with RNA instead of DNA[3]. It remains a focus for therapeutic intervention in HIV infection and associated comorbidities, although no current medicines directly target Tat in clinical practice.
Inhibitors block Tat’s interaction with the TAR RNA element or disrupt recruitment of positive transcription elongation factor b (P-TEFb), thereby reducing HIV transcription and replication[1][4].
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