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J Infect. 2004 Jan;48(1):1-12.

AIDS in Africa: the impact of coinfections on the pathogenesis of HIV-1 infection.

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Department of Cellular and Molecular Medicine: Infectious Diseases, St George's Hospital Medical School, SW17 ORE, London, UK.


The intimate relationship between the HIV-1 life-cycle and the activation state of cells supporting viral replication results in a dynamic interaction between coinfections and HIV-1 replication in dually infected people. The immunologic impact of recurrent coinfections has the potential to increase viral replication, viral genotypic heterogeneity and CD4 T lymphocyte loss, leading to accelerated decline in immune function, reduced survival and increased HIV-1 transmission risk. These effects may play a particularly significant role in the HIV-1 epidemic in sub-Saharan Africa. The mechanisms underlying these effects on virus-host dynamics are reviewed and data describing the impact of tuberculosis, malaria, schistosomiasis and genital ulceration on HIV-1 infection are presented.

[Indexed for MEDLINE]

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