Simian immunodeficiency virus (SIV)-infected macaques on long-term combination antiretroviral treatment (cART) showed evidence of significant astrocyte activation in the lumbar spinal cord despite non-detectable SIV viral load. (A, B) Representative images of lumbar spinal cord from a control (A) and SIV-infected, cART-treated (B) macaques immunostained for the astrocyte marker glial fibrillary acidic protein (GFAP; brown staining indicates positive immunoreactivity). (C) cART-treated animals showed markedly increased GFAP expression in the gray matter compared to controls (p = 0.016, Mann-Whitney). (D) GFAP expression was also significantly higher in the white matter of cART-treated animals, although to a lesser degree (p = 0.021, Mann-Whitney). ROI, region of interest.