title: Immune activation and inflammation in HIV-1 infection: causes and consequences.
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.
authors.affiliation: Cellular Immunology Laboratory, INSERM U543, Hopital Pitie-Salpetriere, Université Pierre et Marie Curie-Paris6, Paris, France. victor.appay@chups.jussieu.fr
authors.forename: V
authors.initials: V
authors.lastname: Appay
authors.forename: D
authors.initials: D
authors.lastname: Sauce
mesh_terms: D000375:Aging / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018450:Disease Progression; D015658:HIV Infections / Q000276:immunology*; D015497:HIV-1; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D008213:Lymphocyte Activation / Q000276:immunology*; D018448:Models, Immunological