AIDS in Africa: the impact of coinfections on the pathogenesis of HIV-1 infection.
The intimate relationship between the HIV-1 life-cycle and the activation state of cells supporting viral replication results in a dynamic interaction between coinfections and HIV-1 replication in dually infected people. The immunologic impact of recurrent coinfections has the potential to increase viral replication, viral genotypic heterogeneity and CD4 T lymphocyte loss, leading to accelerated decline in immune function, reduced survival and increased HIV-1 transmission risk. These effects may play a particularly significant role in the HIV-1 epidemic in sub-Saharan Africa. The mechanisms underlying these effects on virus-host dynamics are reviewed and data describing the impact of tuberculosis, malaria, schistosomiasis and genital ulceration on HIV-1 infection are presented.
Lawn
S D
SD
Department of Cellular and Molecular Medicine: Infectious Diseases, St George's Hospital Medical School, SW17 ORE, London, UK. stevelawn@yahoo.co.uk
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000276:immunology*; D017954:Africa South of the Sahara / Q000453:epidemiology; D015897:Comorbidity; D018450:Disease Progression; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D014779:Virus Replication