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e. Macrophages
Major cellular HIV Reservoir
Infectious virus is retained in macrophages
Are resistant to cytopathic effects of HIV
Contribute to persistence and spread of the
virus
Once ingested by macrophages the virus
escapes immune surveillance.
Virological synapse forms between macrophage
and T cell and the virus is efficiently
transmitted.
Innate Immune Responses to HIV
Infection- Cellular Components
f. Monocytes
Neuropathogenesis of HIV
infection. HIV Dementia
Induction of pro-inflammatory
cytokines and neurotoxins that
disrupt BBB and B-CSF-Barriers
facilitating entry of infected
monocytes into CNS
Adaptive Immune
Response to HIV
The responses come in two forms:
cellular and humoral. The cellular
response refers to the activity of the
CD4 and CD8 T cells, the latter known as
cytotoxic lymphocytes. The humoral
response refers to antibody production
and activity.
Adaptive Immune
Response to HIV
CD8 T cells act against HIV in two different
ways during primary infection:
1. by directly killing HIV-infected cells
2. by secreting anti-HIV molecules such as
chemokines
CD4/CD8 cell ratio: The normal ratio is about 1
to 1.5. If the disease is progressing, CD4 will
decline and CD8 will stay the same or increase
and the CD4/CD8 ratio will be <1, indicating
disease progression
Adaptive Immunity
• Apoptosis
Mechanisms by which HIV
evades the Immune system
• Viral latency
• Inhibition of antigen presentation
• Mutation of viral epitopes compromising
recognition by CTLs or Immunoglobulins- “Viral
escape”
• T cell anergy
• Retention of infectious virus particles sufficient
to maintain a low level of infection, despite the
dramatic decline in plasma viremia
• Escapes Complement Mediated Lysis via RCAs.
HIV Infection- Clinical
Implications
Cardiac manifestations-
premature atherosclerosis, MI,
Myocarditis, Multifocal
Abdominal aortic aneurysms
Wound healing and Graft take
Pre-operative considerations