A hypothesis on HIV and subsequent implications: effectiveness of 'extracellular defense'; pathogenesis; how the...

The inability of herpes simplex virus (HSV) to spread throughout an infected host suggests that the host's immune defense against extracellular HSV is exceptional. Given the basic similarities between HSV and HIV it is reasonable to conclude that the extracellular defense against HIV is similarly potent. HIV hides from this extracellular defense. Because initial hiding place saturation is low, little HIV escapes and it is quickly annihilated. Later, as hiding place saturation increases, the numbers of released HIV increases and the immune system is ultimately overwhelmed. The fact that some perinatally infected infants clear the virus suggests that hiding place saturation is reversible. A critical hiding place re-supplies and increases saturation of other hiding places. The success of bone marrow transplants suggests that bone marrow is a critical hiding place of HIV. The sustained purge of the vulnerable critical hiding place results in a collapse of latency. Steps should be taken to: (1) determine precisely the location of the vulnerable critical hiding place; and (2) determine how to purge this class of cells, as it is purged by infants that clear the virus.