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HIV-specific immune responses
Nov 4, 2002

Hi,

I keep hearing preserving "HIV-specific immune responses", in the context of early treatment during ARS. I am not clear what that means. Could you please explain it?

Thank you very much.

Response from Dr. Young

Thanks for your question.

Our immune system has a vast capacity to recognize and therefore, fight many different foreign invaders-- typically, this is what allows us to fight off bacterial, fungal and viral infections. Not all of this potential is completely protective, and this is why we do get ill with infections from time to time. Nevertheless, this immune capacity is what usually and eventually leads to control of the infection.

The case for HIV starts off the same-- that is to say that our immune system has the ability to recognize, and to an extent, destroy HIV. This capacity is not sufficient to prevent infection, nor eradicate the infection once established; but does seem to limit the amount of viral replication. This is likely why viral loads are lower during established infection than during acute seroconversion.

The sinister issue with HIV infection is that the virus appears to selectively destroy most of the immune response-- namely, the HIV-specific immunity, shortly after (within a few weeks)initial infection. This is part of the rationale for starting therapy in persons with acute infection; to preserve this part of the immune response. It has been suggested that preservation of HIV-specific immunity might lead to better immune control of the virus, leading to lower baseline (or "set point") viral loads and maybe, slower disease progression. -BY



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