HIV disease: fallout from a mucosal catastrophe?

The pathogenesis of human immunodeficiency virus has long been thought to center on a gradual depletion of CD4 + T cells, with an average of 100 cells lost per microliter of blood per year. However, studies of macaques infected with simian immunodeficiency virus and humans infected with human immuno...

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Bibliographic Details
Published in:Nature Immunology 2006-03, Vol.7 (3), p.235-239
Main Authors: Brenchley, Jason M, Price, David A, Douek, Daniel C
Format: Article
Language:English
Subjects:
Animals
Biomedical and Life Sciences
Biomedicine
CD4-Positive T-Lymphocytes - immunology
HIV - immunology
HIV Infections - immunology
Human immunodeficiency virus
Humans
Immune system
Immunology
Infectious Diseases
Lymphocyte Activation - immunology
Macaca
Models, Immunological
Mucous Membrane - immunology
perspective
Simian immunodeficiency virus
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Summary:The pathogenesis of human immunodeficiency virus has long been thought to center on a gradual depletion of CD4 + T cells, with an average of 100 cells lost per microliter of blood per year. However, studies of macaques infected with simian immunodeficiency virus and humans infected with human immunodeficiency virus have shown that the infection rapidly kills most CD4 + T cells at mucosal surfaces. Although most CD4 + T cells reside at these sites, the magnitude of this assault on the immune system is not reflected in the peripheral blood. Here we consider models of human immunodeficiency virus disease pathogenesis given those findings and propose a hypothesis to account for particular aspects of the disease during the chronic phase of infection that can be directly attributed to early depletion of mucosal CD4 + T cells.
ISSN:1529-2908
1529-2916
1365-2567
DOI:10.1038/ni1316