Insights:

For the most part, a silent reservoir of HIV grows in macrophages and CD4 cells where HIV has not integrated its cDNA into the host genome.

Damage occurs when:

1) CD4 cells are activated by MHC class II, resulting in HIV replication leading to apoptosis

2) Direct cytopathic damage to cells by HIV, due to disruption of ribosomes and cell membrane

3) Disruption of the cytoarchitecture of lymph nodes, so they cannot function properly

4) Infection of CNS microglia, leading to neurological damage

Reference

Kumar, V. (2017). Robbins basic pathology international edition. [S.l.]: Elsevier - Health Science.

Abbas, A., Pillai, S. and Lichtman, A. (2018). Cellular and molecular immunology. Philadelphia [etc.]: Elsevier.