Immune activation and inflammation in HIV-1 infection: causes and consequences

J Pathol. 2008 Jan;214(2):231-41. doi: 10.1002/path.2276.

Abstract

Thorough research on HIV is progressively enabling us to understand the intricate mechanisms that link HIV-1 infection to the onset of immunodeficiency. The infection and depletion of CD4(+) T cells represent the most fundamental events in HIV-1 infection. However, in recent years, the role played by chronic immune activation and inflammation in HIV pathogenesis has become increasingly apparent: quite paradoxically, immune activation levels are directly associated with HIV-1 disease progression. In addition, HIV-1-infected patients present intriguing similarities with individuals of old age: their immune systems are characterized by a loss of regenerative capacity and an accumulation of ageing T cells. In this review, we discuss the potential reasons for the establishment of sustained immune activation and inflammation from the early stages of HIV-1 infection, as well as the long-term consequences of this process on the host immune system and health. A simplified model of HIV pathogenesis is proposed, which links together the three major facets of HIV-1 infection: the massive depletion of CD4(+) T cells, the paradoxical immune activation and the exhaustion of regenerative capacity.

Publication types

  • Review

MeSH terms

  • Aging / immunology
  • CD4-Positive T-Lymphocytes / immunology
  • Disease Progression
  • HIV Infections / immunology*
  • HIV-1*
  • Humans
  • Inflammation / immunology*
  • Lymphocyte Activation / immunology*
  • Models, Immunological