hiv medicine 2003

[...]... host factors contributing to the course of HIV infection, including immunological defense mechanisms and genetic factors, will be crucial for our under-standing of the immunopathogenesis of HIV infection and for the development of immunotherapeutic and prophylactic strategies HIV Medicine 2003 – www.HIVMedicine.com The Structure of HIV- 1 17 The Structure of HIV- 1 HIV- 1 is a retrovirus and belongs to the... the serum of HIV- infected patients, suggesting that the immune response selects against CD4-independent viruses (22) Chemokine receptors as co-receptors for HIV entry A milestone for the characterization of the early events leading to HIV- 1 entry was an observation by Cocchi and his coworkers in 1995 CD8+ T cells from HIV- infected patients are HIV Medicine 2003 – www.HIVMedicine.com The HIV Replication... Contents HIV Medicine 2003 – www.HIVMedicine.com Introduction 15 Chapter 1: Pathogenesis of HIV- 1 Infection Andrea Rubbert and Mario Ostrowski Introduction Since the initial description of the human immunodeficiency virus type I (HIV- 1) in 1983 (1,2) and HIV- 2 in 1986 (3), these two viruses have been identified for almost 20 years as the primary cause of the acquired immunodeficiency syndrome (AIDS) As HIV- 1... cell count HIV Medicine 2003 – www.HIVMedicine.com The HIV Replication Cycle 27 The expression of co-receptors on CD4+ lymphocytes depends on their activation level CXCR4 is mainly expressed on naive T cells, whereas CCR5 is present on activated and effector/memory T cells During the early course of HIV- 1 infection, predominantly M-tropic HIV- 1 isolates are detected Interestingly, M-tropic HIV- 1 isolates... should be noted that both IL-1 and TNFα induce NF-kb which binds to the HIV- 1 LTR to promote proviral transcription The importance of an antigen-induced activation of CD4+ T cells is underlined by several in vivo and in vitro studies that demonstrate HIV Medicine 2003 – www.HIVMedicine.com HIV and the Immune System 35 an increase of HIV- 1 replication in association with a tetanus or influenza vaccination... different epitopes than CD8+ T cells from HIV- 1 infected African women (49) This suggests that the epitopes that the immune system is directed against HIV Medicine 2003 – www.HIVMedicine.com HIV and the Immune System 37 during a natural infection might be different from those that are protective against infection HLA class II antigens are crucial for the development of an HIV- 1 specific CD4+ T cell response... Blockade of the RT by the nucleoside inhibitor, zidovudine, was the first at-tempt to inhibit viral replication in HIV- 1 infected patients To-day, numerous nucleoside, nucleotide and non-nucleoside RT inhibitors are available for clinical use and HIV Medicine 2003 – www.HIVMedicine.com The HIV Replication Cycle 29 have broadened the therapeutic arsenal substantially since the mid-eighties Reverse transcription... within the domains that are critical for the induction of conformational changes and that may inhibit membrane fusion HIV Medicine 2003 – www.HIVMedicine.com The HIV Replication Cycle 25 Fig 3: Inhibition of virus entry of CCR5-utilizing (monocytotropic) and CXCR4utilizing (T-cell tropic) HIV isolates by the natural ligands of the chemokine coreceptors CCR5 and CXCR4 T20 is the first of several peptides... non-dividing cells such as macrophages Vpr may stimulate the HIV- LTR in addition to a variety of cellular and viral promoters More recently, vpr was shown to be important for the transport of the viral preintegration complex to the nucleus (overview in: 14) and may arrest cells in the G2 phase of the cell cycle HIV Medicine 2003 – www.HIVMedicine.com The HIV Replication Cycle 21 Vpu is important for the virus... phospholipids and cholesterol In contrast to T cells, where budding occurs at the cell surface and virions are released into the extracellular space, the budding process in monocytes and macroHIV Medicine 2003 – www.HIVMedicine.com HIV and the Immune System 31 phages results in the accumulation of virions within cellular vacuoles The replication of retroviruses is error prone and is characterized by a high spontaneous . lipoprotein membrane. The p24 18 Pathogenesis of HIV- 1 Infection HIV Medicine 2003 – www.HIVMedicine.com core antigen contains two copies of HIV- 1 RNA. The HIV- 1 RNA is part of a protein-nucleic acid. countries, the 16 Pathogenesis of HIV- 1 Infection HIV Medicine 2003 – www.HIVMedicine.com widespread use of HAART is currently not feasible. The further course of the HIV- 1 pandemic therefore mainly. the medical knowledge that is actual today: from December 2002 to January 2003. Because HIV medicine changes so fast, HIV Medicine 2003 will be updated every year. Additional chapters about opportunistic