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Natural immunity
Jan 31, 2003

I have read and heard that some may have a "natural immunity" to HIV. How is this determined? Is it only that they never develope antibodies or symptoms? If they are immune can they still be carriers and pass the virus to others?

Response from Mr. Kull

It is not always possible to determine why some people get HIV infected and some do not. There has been some interesting research conducted on people who have had repeated exposures to HIV, but remain HIV negative.

In order for HIV to infect a person, it first needs to bind to a CD4 cell and then rely on a co-receptor to gain entry into the cell. These co-receptors are referred to as chemokines. Test tube studies have shown that defects in these chemokine receptors prevent HIV's entry into CD4 cells, thereby preventing infection. Epidemiologic studies have identified an association between HIV-negative individuals with repeated high-risk exposures and defects in certain chemokine receptors. However, individuals with defects in certain chemokine receptors have not consistently demonstrated immunity to HIV infection. Chemokine receptors play an important role in understanding HIV infection and developing methods to protect individuals from infection.

If HIV cannot gain entry to CD4 cells and replicate, the virus will not survive in a person's body.

So, while there seems to be convincing evidence that some people are naturally immune to HIV infection, we are not at a point where we can start testing and identifying people who will not get infected despite multiple exposures.

RMK



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