RT Journal Article
SR Electronic
T1 Pathogenesis of HIV: non-specific immune hyperactivity and its implications for vaccines
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 267
OP 271
DO 10.7861/clinmedicine.8-3-267
VO 8
IS 3
A1 Martin Cadogan
A1 Angus G Dalgleish
YR 2008
UL http://www.rcpjournals.org/content/8/3/267.abstract
AB More than a decade ago, the pathogenesis of AIDS was reviewed in this journal, using the subtitle ‘classical and alternative views’, when evidence was accumulating that HIV could not cause AIDS simply through direct cytopathic mechanisms alone. Generalised immune activation after infection with HIV is now understood to be associated with and predictive of disease progression and probably represents the single most important difference between rapid progression and slow or non-progression. However, the fundamental source of this phenomenon remains undetermined. Do pathogenic events after acute infection promote an environment susceptible to increased hyperactivity or does inherent reactivity towards HIV in susceptible individuals ultimately influence these processes? New strategies aimed at eliminating HIV-induced immune activation are required, as is investigation into the clinical and immunological influence of antibodies that target HIV epitopes associated with disease and that are not necessarily neutralising. Therapeutic vaccines to prevent disease may be more practical and effective than classic prophylactic vaccination.