       Document 0909
 DOCN  M95A0909
 TI    New concepts in the immunopathogenesis of HIV infection.
 DT    9510
 AU    Pantaleo G; Fauci AS; Laboratory of Immunoregulation, National Institute
       of Allergy and; Infectious Diseases, National Institutes of Health,
       Bethesda,; Maryland 20892-1876, USA.
 SO    Annu Rev Immunol. 1995;13:487-512. Unique Identifier : AIDSLINE
       MED/95336688
 AB    The typical course of HIV infection is characterized by multiple phases
       that occur over a period of eight to ten years. A critical event in the
       initial establishment of HIV infection is the localization of HIV in
       lymphoid organs that serve as major reservoirs for HIV and as primary
       sites for virus replication. Despite the fact that the majority of
       HIV-infected individuals do not show any clinical signs of disease
       activity for extended periods of time, HIV disease is active and
       progressive in lymphoid organs during this clinically latent period.
       Persistence of virus in lymphoid organs causes a chronic stimulation of
       the immune system that ultimately leads to destruction of the lymphoid
       tissue and loss of the ability to respond to HIV and/or other pathogens.
       Major expansions of restricted subsets of CD8+ T cells determined by the
       usage of certain variable domains (V) of the beta (beta) chain of the T
       cell receptor (TCR) occur in certain patients during primary HIV
       infection. These restricted expansions of CD8+ V beta subsets are
       oligoclonal and represent HIV-specific immune responses with cytolytic T
       cell activity. Although only limited numbers of patients were studied
       thus far, certain patterns have emerged that appear to correlate with
       the subsequent clinical outcome. It is conceivable that immunologic and
       virologic events associated with primary infection have a major impact
       on the ultimate course of HIV disease. Histopathologic, virologic, and
       immunologic studies of long-term nonprogressors (LTNP) indicate that a
       small proportion of patients who have been HIV-infected for
       approximately 10 years have normal lymph node architecture, brisk
       HIV-specific humoral and cellular immune responses, and high and stable
       CD4+ T cell counts serially determined over years. Viral burden and
       expression are low in these patients; however, low levels of viremia are
       present, and virus derived from mononuclear cells is replication
       competent and infectious in most patients. Studies of events associated
       with primary HIV infection, examination of lymphoid tissue at various
       stages of disease, and dissection of the immunologic and virologic
       components of LTNP should contribute substantially to our understanding
       of the pathogenesis of HIV disease.
 DE    Amino Acid Sequence  Base Sequence  DNA/GENETICS  Gene Rearrangement,
       beta-Chain T-Cell Antigen Receptor  Human  HIV Antibodies/BIOSYNTHESIS
       HIV Infections/*ETIOLOGY/IMMUNOLOGY/VIROLOGY  Immunity, Cellular
       Lymphoid Tissue/VIROLOGY  Molecular Sequence Data  T-Lymphocyte
       Subsets/IMMUNOLOGY  Time Factors  JOURNAL ARTICLE  REVIEW  REVIEW,
       TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

