Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
AIDS IN EUROPE, AND THE IMMUNODEFICIENCY OF AIDS
Aids and Infections of Homosexual Men. Second Edition. Ma P and Armstrong D, eds. Boston, Butterworths, p. 311-23 1989.. Unique Identifier : AIDSLINE ICDB/90659648 Hofmann B; Gerstoft J; Lindhardt BO; Dept. of Microbiology and Immunology, Univ. of California Sch. of; Medicine, Los Angeles, CA
Abstract:
AIDS in Europe and aspects of AIDS immunodeficiency are reviewed, including epidemiology, prevalence of HIV antibodies, function of T-cell subsets from patients with AIDS, function of AIDS accessory cells, active suppression of the proliferative responses by AIDS cells or soluble factors, role of cytokines in AIDS, cytotoxic T lymphocytes in AIDS, prognostic factors, and opportunistic infection. By December 1987, cases of AIDS had been reported from all Western European countries. The total number of reported cases was above 10,000, with homosexual men representing 59% of all AIDS cases. In retrospect, the number of diagnosed cases of AIDS per capita in France, Switzerland, and Denmark by 1980 to 1981 matched or even exceeded that in the United States. HIV infection is spreading in Europe, although at different rates in different countries. After becoming infected with HIV, some individuals develop HIV-related clinical symptoms and some of these persons later develop AIDS. If the infection proceeds to AIDS, the general course is a gradual, eventually almost complete disappearance of the CD4+ cells, both in peripheral blood and lymphatic tissues. At the same time, the lymphocyte proliferative response to mitogens and antigens disappears. These events most probably are due to a slow and continuous spread of the HIV infection, which probably is accelerated by activation of CD4+ cells during recurrent infections with other microorganisms. The host defense toward HIV infection has not been delineated. A possible role for cytotoxic T lymphocytes must be anticipated. These cells also could be involved in the destruction of the immune system by eliminating infected cells such as CD4+ cells and the dendritic cells in the follicular clusters of lymph nodes. Because the majority of the cytotoxic cells are CD8+, the infiltration of the follicular centers with CD8+ lymphoblasts could represent a morphologic correlate to the hypothesis. The authors' studies of a cohort of 60 individuals showed that a stabilized proliferative response to pokeweed mitogen (PWM) subdivides anti-HIV-positive individuals into two groups. In the group with low responses to PWM, a high occurrence of AIDS cases seems to indicate a correlation between a low response to PWM and a poor prognosis. Others have found evidence that low PWM responses together with low numbers of CD4+ cells indicate a poor prognosis. (32 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY/IMMUNOLOGY Comparative Study Cross-Cultural Comparison Cross-Sectional Studies Cytotoxicity, Immunologic CD4-Positive T-Lymphocytes/IMMUNOLOGY Europe *Homosexuality Human HIV Seroprevalence Incidence Lymphocyte Transformation Male Opportunistic Infections/*IMMUNOLOGY T-Lymphocytes/IMMUNOLOGY MONOGRAPH REVIEW, TUTORIAL REVIEW 900430
M9040662
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Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
