IMMUNOLOGY OF HIV INFECTION

Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.

IMMUNOLOGY OF HIV INFECTION

Fundamental Immunology. Second Edition. Paul WE, ed. New York, Raven, p. 1059-79, 1989.. Unique Identifier : AIDSLINE ICDB/90665509
Yarchoan R; Broder S; Clinical Oncology Program, NCI, Bethesda, MD 20892

Abstract: Soon after HIV was found to be the cause of AIDS, it was observed that the virus was cytopathic to T4 cells in culture. Also, several pieces of evidence indicated that CD4 (the surface glycoprotein that defines the T4 cell population) was the cellular receptor for HIV and a protein required for the pathogenicity of the virus. It is probable that the immunologic abnormalities in AIDS result in part from a progressive depletion of T4 cells due to their infection and destruction by HIV. Immunology of HIV infection is reviewed under the following headings: clinical manifestations of HIV infection; the T cell, B cell, and monocyte in AIDS; other immune abnormalities in AIDS; immunologic control of HIV; HIV vaccine development; and therapy of HIV infection. While the concept of AIDS is still evolving, it has become clear that the T4 cell is not the only target of HIV infection. HIV can replicate in certain B cells and in monocytes/macrophages, and there is recent evidence that the latter may be the most important target cell in the body. The virus may also infect the bone marrow stem cells, and a number of indirect mechanisms for depletion of T cells have been identified. Clinical progress against AIDS has been possible by adopting strategies to inhibit retroviral replication, even in the face of imperfect knowledge of the immunologic abnormalities. Numerous questions about the nature of AIDS and its therapy remain, such as, why is the T4 rise induced by azidothymidine (AZT) more transient in patients with AIDS than in those with AIDS-related complex? Will drug sanctuary sites be found, or is viral resistance going to be a problem? What is the role of early intervention (eg, with AZT)? (196 Refs)

Keywords: Animal B-Lymphocytes/IMMUNOLOGY CD4-Positive T-Lymphocytes/IMMUNOLOGY Human HIV/IMMUNOLOGY HIV Infections/*IMMUNOLOGY/THERAPY Lymphoma, Non-Hodgkin's/IMMUNOLOGY Monocytes/IMMUNOLOGY Opportunistic Infections/IMMUNOLOGY Sarcoma, Kaposi's/IMMUNOLOGY Skin Neoplasms/IMMUNOLOGY Viral Vaccines/IMMUNOLOGY Virus Replication/IMMUNOLOGY MONOGRAPH REVIEW REVIEW, TUTORIAL
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