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Lancet Infect Dis. 2008 Nov;8(11):675-84. doi: 10.1016/S1473-3099(08)70205-6. Epub 2008 Sep 23.

HIV immunopathogenesis and strategies for intervention.

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Laboratory of Oncology, Department of Cellular and Molecular Medicine, St George's University of London, Tooting, London, UK.


Therapeutic options aimed at tackling the HIV pandemic face many obstacles. The lack of readily accessible and affordable therapies means that most of those affected go untreated. The array of escape mechanisms used by HIV has undermined the efficiency of many antiviral products and continually represents a barrier to the development of an effective vaccine. Recent developments have seen a shift away from a cytopathic viral model of HIV pathogenesis towards the crucial role of immunopathogenic features--notably generalised immune activation--in the development of AIDS. As conventional vaccine strategies have sought to promote viral neutralisation and suppressive cellular responses, novel strategies that aim to address HIV immunopathogenesis should be sought. We review current opinion on HIV-induced pathogenic immune activation and strategies aimed at eliminating HIV, including a potential role for non-neutralising antibodies as part of a therapeutic vaccine option.

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