HIV disease progression rates

Source: Wikipedia, the free encyclopedia.

Following infection with

AIDS
.

Rapid progressors

A small percentage of

AIDS if they fail to take the medication within four years after primary HIV-infection and are termed Rapid Progressors (RP).[4] Indeed, some individuals have been known to progress to AIDS and death within a year after primo-infection. Rapid progression was originally thought to be continent specific, as some studies reported that disease progression is more rapid in Africa,[4][5][6] but others have contested this view.[1][2][7][8]

Long term non-progressors

Main articles:
elite controllers

Another subset of individuals who are persistently infected with HIV-1, but show no signs of disease progression for over 12 years and remain asymptomatic are classified as Long Term Non-Progressors (LTNP). In these individuals, it seems that HIV-infection has been halted with regard to disease progression over an extended period of time.

humoral and cell-mediated responses that seems to delay the progression to AIDS. In some cohorts, individuals who experience signs of progression, but whose clinical and laboratory parameters remain stable over long periods of time, are classified as Long Term Survivors (LTS).[3]

Highly exposed persistently seronegative

There is another, smaller percentage of individuals who have been recently identified. These are called Highly Exposed Persistently Seronegative (HEPS). This is a small group of individuals and has been observed only in a group of uninfected HIV-negative sex workers in

lymphoproliferative activity and have HIV-1 specific CD8+ CTL activity suggesting that transient infection may have occurred.[16][17][18][19] This does not occur in unexposed individuals. What is interesting, is that the CTL epitope specificity differs between HEPS and HIV positive individuals, and in HEPS, the maintenance of responses appears to be dependent upon persistent exposure to HIV.[20]

Prediction of progression rates

During the initial weeks after HIV infection, qualitative differences in the

antibodies in the setting of an extremely low viral load.[13] However, a few reports have correlated the presence of antibodies against Tat in LTNP status.[citation needed
]

HIV subtype variation and effect on progression rates

The HIV-1 subtype that an individual becomes infected with can be a major factor in the rate of progression from

AIDS than individuals infected with subtype A.[31] In Uganda, where subtypes A and D are most prevalent,[32] subtype D is associated with faster disease progression compared with subtype A.[33] Age has also been shown to be a major factor in determining survival and the rate of disease progression, with individuals over 40 years of age at sero-conversion being associated with rapid progression.[34][35][36][37]

Host genetic susceptibility

The Centers for Disease Control and Prevention (CDC) has released findings that genes influence susceptibility to HIV infection and progression to AIDS. HIV enters cells through an interaction with both CD4 and a chemokine receptor of the

CCR5-Δ32 (CCR5 delta 32) delays progression to the condition of AIDS by about 2 years.[citation needed
]

The

genetic mutation. In such research, NIH has found that there exist genetic tests that can determine if a person has this mutation. Implications of a genetic test may in the future allow clinicians to change treatment for the HIV infection according to the genetic makeup of an individual,[38] Currently there exist several at-home tests for the CCR5 mutation in individuals; however, they are not diagnostic tests.[citation needed
]

A relatively new class of drugs for HIV treatment relies on the genetic makeup of the individual.

Entry inhibitors bind to the CCR5 protein to block HIV from binding to the CD4 cell.[citation needed
]

The effect of co-infections on progression rates

dengue virus seems to slow HIV progression rates temporarily.[citation needed
]

See also

References

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    S2CID 35450422
    .
  2. ^
    PMID 11809639
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  3. ^
    PMID 15331610
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  35. S2CID 30898766
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External links
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