Emerging Concepts in the Immunopathogenesis of AIDS

By Daniel C. Douek, Mario Roederer, R. Koup. Annual Review of Medicine, 2009

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There is an intense interplay between HIV and the immune system, and the literature is replete with studies describing various immunological phenomena associated with HIV infection. By definition, HIV is the cause of the immunologic findings, for without HIV there is no AIDS. However, many of the phenomena that have been described seem too broad in scope to be attributable to either direct infection of cells by HIV, or the HIV-specific immune response. Recently, a more fundamental understanding of how HIV impacts upon various T cells and T cell compartments has emerged. This review will cover the role of immune activation in HIV immunopathogenesis, how that activation could be mediated directly by HIV replicating within and damaging the gut mucosal barrier, how HIV affects multiple T cell functions and phenotypes, and how chronic HIV replication induces immune modulatory pathways to negatively regulate certain functions in HIV-specific T cells.

Subfields: Epidemiology, Infectious Diseases, Virology

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