Management

Highly exposed but persistently seronegative individuals The observation that HESN people remain HIV antibody-negative despite repeated exposure to HIV suggests that mechanisms exist to protect humans from HIV infection. Putative immunological and genetic associates of protection from HIV infection in HESN individuals have been identified in cohort studies of infants born to mothers with HIV …

Immunological control of HIV infection in specific patient groups Read More »

Multiple mechanisms exist by which HIV evades specific immune responses. These escape strategies are mutational or constitutive, and result in the evasion of cellular and antibody responses. (Sewell et al., 2000) Mutational escape HIV-specific CTLs kill HIV-infected cells following recognition of viral peptides presented in association with MHC-I molecules on the surface of virally infected …

Escape of HIV from host immune responses Read More »

Mucosal changes and microbial translocation Enterocytes of the gut epithelium show evidence of apoptosis very early after HIV infection, with a peak 14 days following infection. This apoptosis is accompanied by increased epithelial proliferation and the development of regenerative villous enteropathy, which is characterised by villous atrophy plus micro-abscesses. This process is driven both by …

Immune activation in the pathogenesis of HIV disease Read More »

Rationale Antiretroviral therapy alone, by suppressing viral replication, results in marked but incomplete restoration of cell-mediated immunity. Moreover, HIV-specific immune responses decline in people taking cART. In some individuals receiving cART, restoration of total CD4+ T cells is also impaired despite excellent virological control. Current cART strategies are limited by toxicity, cost, adherance, resistance and …

Immune-based therapies for the treatment and prevention of HIV infection Read More »

Immune-based therapies were initially trialled as alternatives or adjuvants to cART, particularly in patients with CD4+ T cell depletion. Subsequently immune modulators have been used to reduce the immune activation associated with HIV infection and, in particular, gut bacterial translocation. Most recent work has focused on the use of immune modulators as a mechanism to …

Eradication of HIV cellular reservoirs and HIV cure Read More »

Abrams, D., Y. Lévy, M.H. Losso, et al. Interleukin-2 therapy in patients with HIV infection. N. Engl. J. Med. 2008; 361:1548–1559. Albert, J., B. Abrahamsson, K. Nagy, E et al Rapid development of isolate-specific neutralizing antibodies after primary HIV-1 infection and consequent emergence of virus variants which resist neutralization by autologous sera. AIDS 1990; 4:107–12. …

References Read More »