Abstract:
PURPOSE OF REVIEW:Differential rates of disease progression are obviously multifactorial, but the virulence of the actual infecting virus is most frequently ignored as potential source of slow or rapid disease progression. In this review, the argument will be made that nearly all elite suppressors are infected by weak HIV-1 strain (in terms of replicative capacity). Whether this poor virus replication is the cause of elite suppression or the consequence of a strong immune response remains a leading question in the field. RECENT FINDINGS:Although numerous research studies have related HIV-1 replicative capacity/fitness in tissue culture to virulence within patients, this review will focus on several recent and key discoveries on the important role of HIV-1 fitness in elite suppression. First, elite suppressors appear to harbor HIV-1 variants that encode Gag, Pol, and Env proteins that are less efficient than their counterparts of HIV-1 in typical/chronic progressors. Second, the actual HIV-1 clone(s) that establish acute infection may be less fit in patients who become elite controllers as compared with typical progressors. Finally, the fitness costs of cytotoxic T lymphocyte escape in HIV-1 may be easily compensated by secondary mutations if the infecting strain is capable of high replication kinetics and rapid evolution. A strain with weak replicative capacity might not compensate for fitness loss or even generate the initial escape mutations. SUMMARY:A combination of good, anti-HIV-1 host genetics (e.g. HLA-B*57) along with infection by a 'whimpy' HIV-1 strain may be necessary for elite suppression, whereas only one of these may lead to slow progression and viremia.
journal_name
Curr Opin HIV AIDSjournal_title
Current opinion in HIV and AIDSauthors
Lobritz MA,Lassen KG,Arts EJdoi
10.1097/COH.0b013e3283454cf5subject
Has Abstractpub_date
2011-05-01 00:00:00pages
214-20issue
3eissn
1746-630Xissn
1746-6318journal_volume
6pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:The purpose is to review recent insights into the impact of HIV-associated immune activation on AIDS and non-AIDS morbidity and mortality. RECENT FINDINGS:Immune activation has long been recognized as an important consequence of untreated HIV infection and predictor of AIDS progression, which decline...
journal_title:Current opinion in HIV and AIDS
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journal_title:Current opinion in HIV and AIDS
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journal_title:Current opinion in HIV and AIDS
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journal_title:Current opinion in HIV and AIDS
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journal_title:Current opinion in HIV and AIDS
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journal_title:Current opinion in HIV and AIDS
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abstract:PURPOSE OF REVIEW:To describe the changes in the presentation of HIV-associated neurocognitive disorders (HAND) comparing the current combination antiretroviral therapy (cART) treatment era to the pre-cART era. RECENT FINDINGS:The frequency of the most severe stage of HAND, HIV-associated dementia (HAD), has decreased...
journal_title:Current opinion in HIV and AIDS
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journal_title:Current opinion in HIV and AIDS
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journal_title:Current opinion in HIV and AIDS
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更新日期:2012-01-01 00:00:00
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journal_title:Current opinion in HIV and AIDS
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更新日期:2009-07-01 00:00:00
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journal_title:Current opinion in HIV and AIDS
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journal_title:Current opinion in HIV and AIDS
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journal_title:Current opinion in HIV and AIDS
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journal_title:Current opinion in HIV and AIDS
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journal_title:Current opinion in HIV and AIDS
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