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Retrovirus Life Cycles01:10

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Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the retrovirus to...

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Low postseroconversion CD4 count and rapid decrease of CD4 density identify HIV+ fast progressors.

Annette Audigé1, Patrick Taffé, Martin Rickenbach

  • 1Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.

AIDS Research and Human Retroviruses
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CD4 density on T cells decreases over time in HIV+ patients, particularly in fast progressors. This decline, even with antiretroviral therapy (ART), may indicate persistent immune dysfunction and impact disease progression.

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Published on: September 26, 2011

Area of Science:

  • Immunology
  • Virology
  • HIV/AIDS Research

Background:

  • Human Immunodeficiency Virus (HIV) entry necessitates high CD4 cell surface density, yet replication requires CD4 down-modulation, presenting a paradox.
  • Understanding how CD4 density changes over time in HIV-positive (HIV+) individuals and its correlation with disease progression is crucial for managing HIV infection.

Purpose of the Study:

  • To longitudinally quantify CD4 densities on CD4+ T cells and monocytes in ART-naive HIV+ patients with varying disease progression rates.
  • To investigate the role of CD4 density in HIV disease progression and its relationship with post-seroconversion CD4 counts.

Main Methods:

  • Retrospective study defining three patient groups based on CD4+ T cell loss rate: fast (<7.5 years), intermediate (7.5-12 years), and slow progressors (>12 years).
  • Mathematical modeling to determine post-seroconversion CD4 counts and longitudinal CD4 profiles.
  • Flow cytometry used to quantify CD4 densities on CD4+ T cells and monocytes from HIV+ patients and healthy controls.

Main Results:

  • Fast progressors exhibited significantly lower post-seroconversion CD4 counts compared to other groups.
  • HIV+ patients showed lower T cell CD4 density than healthy individuals, with a more rapid decrease observed in fast progressors.
  • Antiretroviral therapy (ART) did not restore normal CD4 density levels.

Conclusions:

  • Post-seroconversion CD4 counts can predict individual HIV disease progression rates, potentially identifying patients who would benefit most from early ART initiation.
  • A faster decline in CD4 density may contribute to immune functional impairments in advanced HIV infection.
  • The lack of ART's effect on CD4 density suggests persistent immune dysfunction in uncontrolled HIV infection.