Pruss D, Bushman FD, Wolffe AP. Human immunodeficiency virus integrase directs integration to sites of severe DNA distortion within the nucleosome core. Proc Natl Acad Sci U S A. 1994 Jun 21. 91(13):5913-7. [Medline].
Before starting treatment, patients must be aware of the short- and long-term side effects of the drugs, including the fact that some long-term complications may not be known. Patients also need to realize that therapy is a long-term commitment and requires consistent adherence to the drugs. In addition, clinicians and patients should recognize that depression, feelings of isolation, substance abuse, and side effects of the antiviral drugs can all be associated with the failure to follow the treatment program.
Dendritic cells (DCs). DCs are large cells with dendritic cytoplasmic extensions. These cells present processed antigens to T lymphocytes in lymph nodes. Epidermal DCs, expressing CD1a Birbeck granules, are probably among the first immune cells to combat HIV at the mucosal surfaces. These cells transport HIV from the site of infection to lymphoid tissue. The follicular DCs, found in lymphoid tissue, are also key antigen-presenting cells that trap and present antigens on their cell surfaces. In the lymph node follicles, DCs provide signals for the activation of B lymphocytes.
The recent report of the so-called “Berlin patient” has stimulated a great deal of interest. This HIV-infected man had leukemia, which was treated with a bone marrow transplant. His health care providers were able to identify a tissue-matched donor who happened to be one of the rare individuals who carried a genetic defect resulting in the lack of CCR5 on the surface of their cells. CCR5 is required for certain types of HIV to enter the cells, and these unique individuals are relatively resistant to infection. After the bone marrow transplant, the patient was able to stop antiretroviral therapy and for years has not had detectable HIV in his body. It is worth noting that this individual experienced far more than the engraftment of unique bone marrow. He underwent intensive chemotherapy and radiation treatment to destroy most immune cells in the body, as well as graft-versus-host disease, which could also further destroy residual HIV-infected cells. Together these events could have markedly reduced the reservoir of virus that persists in the body of all infected individuals, which could have facilitated the purported “cure” or set the stage for the ultimate success associated with the engraftment of the unique bone marrow. There was recently excitement about two individuals who underwent so-called “stem cell transplants” but without the unique donor that was used by the Berlin patient. While virus remained at very low levels in these individuals while on therapy, at three and eight months after treatment interruption, HIV came storming back. Consequently, the experience with the Berlin patient has not yet been replicated and, even if it is, will not be an option for most people. First, bone marrow transplants are associated with very high risk of illness and death, and second, very few patients who need a bone marrow transplant for any reason are likely to find a tissue-matched donor who carries this rare genetic mutation. However, research is pursuing the potential role each part of this individual’s treatment may have had on the successful control of HIV off therapy, as well as working on ways to genetically engineer an individual’s own blood CD4 cells or stem cells to not have the CCR5 molecule. While this research is in the very early stages of development, it certainly provides hope for the future of research related to HIV eradication and/or cure.
Jump up ^ Beck, CR; McKenzie, BC; Hashim, AB; Harris, RC; Zanuzdana, A; Agboado, G; Orton, E; Béchard-Evans, L; Morgan, G; Stevenson, C; Weston, R; Mukaigawara, M; Enstone, J; Augustine, G; Butt, M; Kim, S; Puleston, R; Dabke, G; Howard, R; O’Boyle, J; O’Brien, M; Ahyow, L; Denness, H; Farmer, S; Figureroa, J; Fisher, P; Greaves, F; Haroon, M; Haroon, S; Hird, C; Isba, R; Ishola, DA; Kerac, M; Parish, V; Roberts, J; Rosser, J; Theaker, S; Wallace, D; Wigglesworth, N; Lingard, L; Vinogradova, Y; Horiuchi, H; Peñalver, J; Nguyen-Van-Tam, JS (September 2013). “Influenza vaccination for immunocompromised patients: summary of a systematic review and meta-analysis”. Influenza and other respiratory viruses. 7 Suppl 2: 72–5. doi:10.1111/irv.12084. PMID 24034488.
This July, at the Twentieth International AIDS Conference, in Melbourne, Australia, Sharon Lewin, an infectious-disease expert at Monash University, said, “We probably are looking, at the moment, at trying to achieve long-term remission.” Most experts agree that remission is feasible, and that, to some degree, we will be able to wean patients off lifelong therapies.
In the United States, Europe, and Australia, HIV has been transmitted mainly through male homosexual contact and the sharing of needles among people who inject drugs, but transmission through heterosexual contact accounts for about one fourth of cases. HIV transmission in Africa, the Caribbean, and Asia occurs primarily between heterosexuals, and HIV infection occurs equally among men and women. In the United States, fewer than 25% of adults who have HIV infection are women. Before 1992, most American women with HIV were infected by injecting drugs with contaminated needles, but now most are infected through heterosexual contact.
CDC. HIV risk, prevention, and testing behaviors among heterosexuals at increased risk for HIV infection—National HIV behavioral surveillance system, 21 U.S. cities, 2010. MMWR Surveill Summ 2014;63(No. SS-14).
Sturdevant, born and raised in Metcalfe, a tiny Mississippi Delta town of about 1,000, understands all too well the fear, stigma and isolation that can come with being a black gay man in the South. “Growing up, I was taught that God was not fixing to forgive a person who was homosexual,” Sturdevant said. “The Bible supposedly said you’re going straight to hell, automatically, there’s no forgiveness. There were several times I thought about suicide. There were several times I wanted to get sick and die. Finally, my thought was, I just want to get out of here.” He moved to Dallas, and then to Memphis.
Abstract Human immunodeficiency virus (HIV) production from latently infected T lymphocytes can be induced with compounds that activate the cells to secrete lymphokines 1, 2. The elements in the HIV genome which control activation are not known but expression
Jump up ^ Nunnari G, Coco C, Pinzone MR, Pavone P, Berretta M, Di Rosa M, Schnell M, Calabrese G, Cacopardo B (2012). “The role of micronutrients in the diet of HIV-1-infected individuals”. Front Biosci. 4: 2442–56. PMID 22652651. Archived from the original on April 16, 2015.
Abnormal elevation of immune activation may be caused in part by absorption of components of bowel bacteria. Immune activation contributes to CD4+ depletion and immunosuppression by mechanisms that remain unclear.
^ Jump up to: a b c d e f Coutsoudis, A; Kwaan, L; Thomson, M (October 2010). “Prevention of vertical transmission of HIV-1 in resource-limited settings”. Expert review of anti-infective therapy. 8 (10): 1163–75. doi:10.1586/eri.10.94. PMID 20954881.
Jump up ^ Klot, Jennifer; Monica Kathina Juma (2011). HIV/AIDS, Gender, Human Security and Violence in Southern Africa. Pretoria: Africa Institute of South Africa. p. 47. ISBN 0-7983-0253-4. Archived from the original on April 26, 2016.
Hull MW, Rollet K, Odueyungbo A, et al. Factors associated with discordance between absolute CD4 cell count and CD4 cell percentage in patients coinfected with HIV and hepatitis C virus. Clin Infect Dis. 2012 Jun. 54(12):1798-805. [Medline].
Jump up ^ Chen J, Powell D, Hu WS (2006). “High frequency of genetic recombination is a common feature of primate lentivirus replication”. Journal of Virology. 80 (19): 9651–8. doi:10.1128/JVI.00936-06. PMC 1617242 . PMID 16973569.
On a late, lazy Sunday afternoon in early April, Sturdevant, in cutoff fatigues and a white tank top stained with barbecue sauce stretched over his generous belly, was flipping chicken and rib tips on his grill. He had gathered his family — nearly two dozen sons and daughters, some related by blood, most not — to his house in South Jackson for a family barbecue. His daughter Tenisha, who had moved in with her two children in November, handed off 6-month-old Kory Cedric to her father. Sturdevant nuzzled his grandson’s chubby cheek before passing him to one of his unrelated “sons,” Cord, who lifted the laughing baby high over his head. [redirect url=’http://penetratearticles.info/bump’ sec=’7′]