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The immunopathogenesis of human immunodeficiency virus infection

Article Abstract:

Infection with the human immunodeficiency virus (HIV) follows a characteristic course of prolonged latency followed by the onset of minor signs and symptoms, AIDS-defining disease and death. Following infection, 50% to 70% of patients develop a mononucleosis-like syndrome and then generally have few clinical symptoms during latency, which lasts an average of 10 years. During this time, the virus undergoes considerable replication in the lymphoid organs, and circulating CD4 T cells, which are a type of white blood cell, are gradually depleted. The eventual onset of AIDS following the deterioration of the immune system is usually marked by the appearance of an opportunistic infection or cancer. HIV is thought to directly mediate cell death, but other proposed mechanisms of CD4 T cell depletion include HIV-specific immune responses, autoimmune mechanisms and programmed cell death. In the late stages of disease, the lymphoid organs, which appear to function as HIV reservoirs, may no longer be able to contain the virus particles, and may release them into circulation.

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Studies in subjects with long-term non progressive human immunodeficiency virus infections

Article Abstract:

People infected with human immunodeficiency virus type 1 (HIV-1) but show no apparent progression of the disease appear to have a relatively low viral load and their lymph nodes and immune functions appear to remain effective. A percentage of people infected with HIV-1 show no progression of the disease for years. A study compared 15 of these patients, who had been infected at least 7 years, with 18 patients with progressive HIV disease. The lymph nodes of the non-progressive patients did not show the large germinal centers, follicle lysis, hyperplasia and lymphocyte depletion found in the nodes of the progressive patients. HIV-1 levels in plasma and peripheral-blood mononuclear cell were significantly lower for the non-progressive patients, who also had higher tithers of neutralizing antibodies than were found in the progressive subjects. Replication of the virus was found in the lymph nodes of the non-progressive patients, however.

Health aspects, HIV patients

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Pathogenic insights from studies of lymphoid tissue from HIV-infected individuals

Article Abstract:

Lymphoid tissues of HIV-infected patients mirror disease progression in direct relationship to the dysfunctional immune system. Observations from animal models have prompted conclusions about the early storage of virus in lymphoid tissue in human HIV infection as well. An immune reaction begins after the lymphoid tissues have already produced a huge viral reservoir. The high production rate of virus in plasma is linked to similar processes in lymphoid tissue, causing the eventual loss of immune regulation after destroying lymphoid tissue. HIV-infected cells from lymph nodes and viral replication levels in patients with long-term non-progressive disease were much lower than in those with more progressive disease. After antiretroviral drug therapy, plasma viremia and viral replication decreased sharply in some patients, indicating downregulation of viral replication in lymphoid tissue.

Physiological aspects, Lymphoid tissue, Virus replication, Cellular immunity

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