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acquired immune deficiency syndrome (AIDS) 7 acquired immune deficiency syndrome (AIDS)
Antibodies in solution
Africa attributable to HIV-2. Principal transmission routes
include sexual contact, parenteral inoculation, and passage
of the virus from infected mothers to their newborns.
Although originally recognized in homosexual or bisexual
men in the United States, AIDS is increasingly a heterosexual
disease. It appears to have originated in Africa, where it
is a heterosexual disease, and it has been reported in more
Homologous antigen
linked to an insoluble
particle
Antigen/antibody
complexes
Absorption is the elimination of antibodies from the mixture by adding soluble antigens or the elimination of soluble antigen from a mixture by adding
antibodies.
Fab
Hinge
region
COOH
527
NH 2
1 CL
236
276
VL
Abzyme (59D8-tPA).
Acanthosis nigricans.
CH
VH
Ab
portion
Enzyme
portion
Hyperkeratosis
Epidermis
Papillary dermis
Reticular dermis
Antigen
Accessory cell MHC Class II
(monocyte, macrophage,
dendritic cell or Langerhans cell)
Accessory molecules.
T cell receptor
(TCR)
T cell
than 193 countries. The CD4 molecules on T lymphocytes
serve as high affinity receptors for HIV. HIVgp 120 must
also bind to other cell surface molecules termed coreceptors
for cell entry. They include CCR5 and CXCR4 receptors
for β chemokines and α chemokines. Some HIV strains are
macrophage tropic, whereas others are T cell tropic. Early
in the disease, HIV colonizes the lymphoid organs. The
striking decrease in CD4 + T cells is a hallmark of AIDS
that accounts for the immunodeficiency late in the course
of HIV infection, but qualitative defects in T lymphocytes
may be discovered in HIV-infected persons who are
asymptomatic. Infection of macrophages and monocytes is
very important, and the dendritic cells in lymphoid tissues
are the principal sites of HIV infection and persistence.
In addition to the lymphoid system, the nervous system
is the major target of HIV infection. It is widely accepted
that HIV is carried to the brain by infected monocytes.
The microglia in the brain are the principal cell types
infected in that tissue. The natural history of HIV infection
is divided into three phases: (1) early acute, (2) middle
chronic, and (3) final crisis. Viremia, measured as HIV-1
RNA, is the best marker of HIV disease progression and
is valuable clinically in the management of HIV-infected
patients. Clinically, HIV infection can range from a mild
acute illness to a severe disease. The adult AIDS patient
may present with fever, weight loss, diarrhea, generalized
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