Determinants of protection among HIV‐exposed seronegative persons: an overview.
Both clinical experience and a growing medical literature indicate that some persons who have been exposed to human immunodeficiency virus (HIV) infection remain uninfected. Although in some instances this may represent good fortune, cohorts of uninfected persons have been reported who are considered at high risk for infection. In these cohorts a variety of characteristics have been proposed as mediating protection, but to date only the 32&#x2013;base pair deletion in the chemokine (C&#x2010;C motif) receptor 5 gene, which results in complete failure of cell surface expression of this coreceptor, has been associated with high&#x2010;level protection from HIV infection. With this in mind, there are probably many other factors that may individually or in combination provide some level of protection from acquisition of HIV infection. Because some of these factors are probably incompletely protective or inconsistently active, identifying them with confidence will be difficult. Nonetheless, clarifying the determinants of protection against HIV infection is a high priority that will require careful selection of high&#x2010;risk uninfected cohorts, who should undergo targeted studies of plausible mediators and broad screening for unexpected determinants of protection.
Lederman
Michael M
MM
Center for AIDS Research, Case Western Reserve University School of Medicine, University Hospitals/Case Medical Center, Cleveland, OH 44106, USA. MXL6@case.edu
Alter
Galit
G
Daskalakis
Demetre C
DC
Rodriguez
Benigno
B
Sieg
Scott F
SF
Hardy
Gareth
G
Cho
Michael
M
Anthony
Donald
D
Harding
Clifford
C
Weinberg
Aaron
A
Silverman
Robert H
RH
Douek
Daniel C
DC
Margolis
Leonid
L
Goldstein
David B
DB
Carrington
Mary
M
Goedert
James J
JJ
D006678:HIV / Q000276:immunology*; D015658:HIV Infections / Q000235:genetics* / Q000276:immunology*; D006801:Humans; D007113:Immunity, Innate; D019713:Receptors, CCR5 / Q000235:genetics; D015728:Receptors, HIV / Q000235:genetics
D019713:Receptors, CCR5; D015728:Receptors, HIV