IMMUNITY ACTIVATION IN HIV INFECTION

Abstract

This review article concerns a challenging problem of HIV infection, immune activation. The processes of immune activation largely determine CD4+T cell depletion, leading to development of AIDS-associated and non-AIDS-related diseases. Immune activation indices are also strong predictors of the clinical outcome. Activation in HIV-infection affects both innate and adaptive immune cells, leads to increased proinflammatory cytokine production and blood coagulation. The reasons for immune activation may include different pathogens (HIV, cytomegalovirus, Epstein–Barr virus, hepatitis C virus), lymphopenia and lymphopenia-induced T lymphocyte homeostatic proliferation, transfer of microbial products from the gut, due to profound CD4+T cell deficiency in lamina propria and altered permeability of intestinal barrier. Other factors that promote the process of immune activation are as follows: T lymphocyte "bystander" activation, increased T cell turnover, and systemic inflammation development. The review covers pathogenic mechanisms HIV-infection associated with immune activation, like as description of different laboratory parameters characterizing its manifestations in HIV-infected patients. Significance and prognostic role of these parameters in assessing efficiency of antiretroviral therapy, development of complications, and adverse outcomes of infection are presented as well.