[Selected aspects of the immunopathogenesis of HIV infection]

Abstract

This review describes a current view on immunopathogenesis of HIV infection including potential causes of immune failure in control of the infection. Above all, the role of different components of immune system is being discussed. Their interplay is disturbed during interaction with the virus and determines the course of the infection. HIV primary infection causes depletion of CD4+ effector memory T cells in extra-lymphoid compartments that are first replaced by CD4+ T cells proliferation. However, at the end the regenerative capacity is exhausted and opportunistic infections occur. A crucial role in controlling HIV replication is played by HIV-specific cytotoxic CD8+ T cells that eliminate virus-infected cells and delay progression of the infection. Thus, the majority of vaccination strategies is based on stimulation of a potent cytotoxic response. Chronic nonspecific immune activation that gradually destroys functional organization of immune system has been well documented in HIV+ patients. Also, several circulating microbial products from gastrointestinal tract have been recently suggested as a cause of chronic immune activation following depletion of mucosal CD4+ T cells and intestinal mucosa damage. Better understanding of immunopathogenetic mechanisms of HIV infection is necessary to determine further aims for immunotherapeutic interventions and vaccination strategies.