The Course Of Hiv Infection

AIDS results from infection by the human immunodeficiency virus, or HIV. Once HIV has entered the bloodstream, HIV binds to CD4, a receptor protein on the surface of some cells. To enter a cell, HIV must also bind to an associated protein, or co-receptor. Macrophages, which have the CD4 receptor and a co-receptor called CCR5, are often the first cells of the immune system infected with HIV. The virus replicates inside the macrophages, and new viruses are released through "budding." This process does not destroy the macrophages. Viral replication of HIV results in many mutations. Eventually, a mutation may enable the virus to recognize other co-receptors, such as those found on helper T cells.

After release from macrophages, HIV attaches to and enters helper T cells. After viral replication, the new viruses are released from the T cell, as shown in Figure 47-10. These viruses then attach to other helper T cells, where the process repeats. Unlike macrophages, helper T cells are destroyed. Eventually, HIV kills enough helper T cells to cripple the immune system, leading to AIDS. HIV infection doesn't progress to AIDS on a specific timetable, but people tend to go through three phases of infection.

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