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Chapter 4 : Acute HIV Infection and Cells Susceptible to HIV Infection

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Acute HIV Infection and Cells Susceptible to HIV Infection, Page 1 of 2

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Abstract:

This chapter covers the events surrounding acute HIV infection of the host following transmission. It reviews the clinical and laboratory findings in primary infection, the first cells infected, and the large variety of cells in the body that are susceptible to HIV infection. Acute virus infection is characterized by a clinical state (the acute retroviral syndrome) that involves a flulike illness and often a macular-papular rash. This clinical syndrome occurs in 50 to 90% of infected people and generally predicts a more rapid clinical course. Detection of anti-HIV antibodies is performed by an enzyme-linked immunosorbent assay (ELISA) technique and confirmed by supplemental testing (e.g., immunoblotting or indirect immunofluorescence assay). HIV can be transmitted from the mucosae by trancytosis involving the basolateral layer of epithelial cells. High viral replication during the acute syndrome is subsequently reduced, most probably reflecting cell-mediated immune activities. A polyclonal CD8 cell response reflected by the T-cell repertoire is associated with a better prognostic course. Neutralizing antibodies are not frequently detected in primary infection. In the bowel, a variety of mucosal cells can be infected, but they may be detected at a low level in comparison to the large number of infected CD4 lymphocytes and macrophages infected in the gastrointestinal tract. In the host, superinfection can occur but resistance may be established once the immune system has responded effectively (i.e., in chronic infection). Recombination does not involve an HIV-1 and HIV-2 isolate because the RNA dimer initiation hairpin sites are different.

Citation: Levy J. 2007. Acute HIV Infection and Cells Susceptible to HIV Infection, p 79-108. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch04

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Innate Immune System
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Figures

Image of Figure 4.1
Figure 4.1

Estimated time course for host immune response to acute HIV infection. *, neutralizing antibodies are often directed at earlier virus and not the virus present in the blood at that time in the individual. CD8 cell anti-HIV responses are both cytotoxic and noncytotoxic.

Citation: Levy J. 2007. Acute HIV Infection and Cells Susceptible to HIV Infection, p 79-108. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch04
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Image of Figure 4.2
Figure 4.2

Variation in HIV replication in peripheral blood mononuclear cells (PBMC). The cells from 11 different donors of Asian (bars A to D), African-American (bars E, F, and G), and Caucasian (bars H to K) backgrounds were infected with three different strains of HIV-1 (SF2 [A], SF247 [B], and SF170 [C]). Reproducible differences in level of replication and time of maximum virus release (number above bar) were observed. Modified from reference 1230 with permission. Copyright 1987 The American Association of Immunologists, Inc.

Citation: Levy J. 2007. Acute HIV Infection and Cells Susceptible to HIV Infection, p 79-108. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch04
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Image of Figure 4.3
Figure 4.3

Steps involved in recombination. This diagram illustrates how recombinants can be generated during reverse transcription through strand transfer. The plus-strand genomic RNAs of two genetically distinct HIV variants coinfecting a cell are shown. In the example shown here, reverse transcriptase (represented as a gray rectangle) initiates synthesis using the plus-strand genomic RNA of variant A as a template. As synthesis proceeds, conditions may arise that cause the reverse transcription and the nascent minus-strand DNA copied from variant A (shown as a dotted black line) to transfer to the variant B genomic RNA. Synthesis then proceeds, using the variant B genomic RNA as a template (shown as a dotted line). The resultant proviral DNA contains sequence information from both variants A and B. The process outlined here is referred to as strand transfer and can be carried out by reverse transcriptase in vitro. Provided by L. Demeter.

Citation: Levy J. 2007. Acute HIV Infection and Cells Susceptible to HIV Infection, p 79-108. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch04
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Download as Powerpoint

References

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Tables

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Table 4.1

Characteristics of acute HIV infection

Citation: Levy J. 2007. Acute HIV Infection and Cells Susceptible to HIV Infection, p 79-108. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch04
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Table 4.2

Laboratory stages of primary HIV infection based on the emergence of viral markers

Citation: Levy J. 2007. Acute HIV Infection and Cells Susceptible to HIV Infection, p 79-108. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch04
Generic image for table
Table 4.3

Human cells susceptible to HIV infection

Citation: Levy J. 2007. Acute HIV Infection and Cells Susceptible to HIV Infection, p 79-108. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch04
Generic image for table
Table 4.4

Timing of virus spread after intravaginal SIV inoculation

Citation: Levy J. 2007. Acute HIV Infection and Cells Susceptible to HIV Infection, p 79-108. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch04
Generic image for table
Table 4.5

Chemokine receptor levels on CD4 cells

Citation: Levy J. 2007. Acute HIV Infection and Cells Susceptible to HIV Infection, p 79-108. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch04
Generic image for table
Table 4.6

Factors influencing HIV infection and replication

Citation: Levy J. 2007. Acute HIV Infection and Cells Susceptible to HIV Infection, p 79-108. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch04
Generic image for table
Table 4.7

Classification of HIV isolates by biologic properties

Citation: Levy J. 2007. Acute HIV Infection and Cells Susceptible to HIV Infection, p 79-108. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch04
Generic image for table
Table 4.8

Factors involved in resistance to virus superinfection

Citation: Levy J. 2007. Acute HIV Infection and Cells Susceptible to HIV Infection, p 79-108. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch04

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