Immune activation is a dominant factor in the pathogenesis of African AIDS

Bentwich, Zvi; Kalinkovich, Alexander; Weisman, Z.

doi:10.1016/0167-5699(95)80119-7

Cited by 346 publications

(278 citation statements)

References 43 publications

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“…This accounts for the sometimes polar outcomes of the response with the same 'players'. We believe that this also holds true for the scene in Africa and the developing world, where immune activation is continuous and the result of chronic persistent stimulation [8,32] other developing countries, a much greater emphasis on the eradication of helminth infections should be given priority. Such eradication may modulate the baseline immune response and lead to improved ability to cope with infections.…”

Section: Discussionmentioning

confidence: 86%

Immune dysregulation to Ethiopian immigrants in Israel: relevance to helminth infections?

Bentwich

Weisman

Moroz

et al. 1996

Clinical and Experimental Immunology

134

110

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SUMMARYThe infectious disease background and particularly the helminth infections that are endemic in Africa could have profound effects on the host immune system. Studies that we have performed on an Ethiopian HIV ÿ immigrant population that has recently reached Israel, lend support to this notion. They have indeed revealed a very high prevalence of helminth and several other infections with an extreme immune dysregulation, consisting of: (i) highly elevated plasma IgE, IgG, placental isoferritin, p75 soluble TNF receptor (sTNFR) levels and very high blood eosinophilia; (ii) increased secretion from phytohaemagglutinin (PHA)-simulated peripheral blood mononuclear cells (PBMC) of the cytokines IL-2, IL-4, IL-10 and p75s sTNFR, and decreased secretion of interferon-gamma (IFN-) and IL-6; (iii) increased and decreased surface expression of p75 TNFR and IL-6 receptor on lymphocytes, respectively. The causal relationship between this immune dysregulation and the infectious background is highly suggestive, and could have far-reaching implications in the resistance to other infections.

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Section: Discussionmentioning

confidence: 86%

Immune dysregulation to Ethiopian immigrants in Israel: relevance to helminth infections?

Bentwich

Weisman

Moroz

et al. 1996

Clinical and Experimental Immunology

134

110

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“…In addition, the increase of effector CD8 þ T cells in HIV ¹ Ethiopians versus HIV ¹ Dutch could result in increased production of cytokines such as tumour necrosis factor-alpha (TNF-a) and interferon-gamma (IFN-g), potentially stimulating HIV-1 replication after infection. The above assumptions could contribute to the reported faster progression of HIV-1 infection in an African context [19,20].…”

Section: Discussionmentioning

confidence: 98%

“…This activation has been attributed to an increased load of environmental pathogens, especially intestinal parasites in Ethiopia, compared with industrialized countries [20]. The activated state of the immune system in Ethiopians is reflected by increased effector CD8 þ T cells, increased T cells associated with repeated antigenic stimulation (containing Th2 cells).…”

Section: Discussionmentioning

confidence: 99%

“…Studies have suggested that HIV disease progression is faster in Africa when compared with industrialized countries [19]. Pre-existent immune activation as a result of highly prevalent infectious diseases and also nutritional factors have been suggested as important contributors to this altered HIV disease progression in Africa [20][21][22][23][24]. There are not many reports detailing the immune status of HIV-infected and non-infected Africans.…”

Section: Introductionmentioning

confidence: 99%

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Reduced naive and increased activated CD4 and CD8 cells in healthy adult Ethiopians compared with their Dutch counterparts

Messele¹,

Abdulkadir²,

Fontanet³

et al. 1999

Clinical and Experimental Immunology

104

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SUMMARYTo assess possible differences in immune status, proportions and absolute numbers of subsets of CD4 þ and CD8 þ T cells were compared between HIV ¹ healthy Ethiopians (n ¼ 52) and HIV ¹ Dutch (n ¼ 60). Both proportions and absolute numbers of naive CD4 þ and CD8 þ T cells were found to be significantly reduced in HIV ¹ Ethiopians compared with HIV ¹ Dutch subjects. Also, both proportions and absolute numbers of the effector CD8 þ T cell population as well as the CD4 þ CD45RA ¹ CD27 ¹ and CD8 þ CD45RA ¹ CD27 ¹ T cell populations were increased in Ethiopians. Finally, both proportions and absolute numbers of CD4 þ and CD8 þ T cells expressing CD28 were significantly reduced in Ethiopians versus Dutch. In addition, the possible association between the described subsets and HIV status was studied by comparing the above 52 HIV ¹ individuals with 32 HIV þ Ethiopians with CD4 counts > 200/ml and/or no AIDS-defining conditions and 39 HIV þ Ethiopians with CD4 counts < 200/ml or with AIDS-defining conditions. There was a gradual increase of activated CD4 þ and CD8 þ T cells, a decrease of CD8 þ T cells expressing CD28 and a decrease of effector CD8 þ T cells when moving from HIV ¹ to AIDS. Furthermore, a decrease of naive CD8 þ T cells and an increase of memory CD8 þ T cells in AIDS patients were observed. These results suggest a generally and persistently activated immune system in HIV ¹ Ethiopians. The potential consequences of this are discussed, in relation to HIV infection.

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“…'~: widely to evaluate HIV progression in Africa. (12)(13)(14)(15), which might devaluate activation markers as markers for HIV disease. This could depend on the population studied; these results, our previous experience with Zambian tuberculosis patients (5) and studies of HI V infection in other parts of the continent (10,16) show that immune activation markers are valuable in the assessment of African patients.…”

Section: Discussionmentioning

confidence: 99%

Neopterin and other indicators of HIV progression in Zambian adults

Hosp¹,

Quigley²,

Mwinga³

et al. 2000

Pteridines

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In this study, we assessed a possible correlation of CD4 counts with the low-cost progression markers neopterin, 132-microglobulin (B2M), total lymphocyte count (TLC) and hemoglobin, and we investigated associations between progression :narkers and clinical parameters in HIV -1 seropositive Zambians. Of 147 HIV-1 seropositive patients presenting to an outpatient clinic in Lusaka, blood was taken for CD4 counts, serum progression markers and full blood count. A detailed clinical history and medical examination was taken at that point, and the patients were seen 3··monthly over the following 12 months. Further CD4 counts were taken after 6 and 12 months. Neopterin, B2M: lymphocyte count, and hemoglobin showed a strong correlation with CD4 count. Of the serum progression markers, neopterin was more sensitive than B2M to detect HIV related symptoms and to predict weight loss and death in the follow-up period. Lymphocyte count and hemoglobin were significantly lower in patients with oral candidiasis and those falling sick or dying in the follow-up period . Hemoglobin was also associated with past diarrhoea. When stratified by sex, the associations of hemoglobin were very strong in males, but weakel' in females . In conclusion, neopterin and B2M correlate well with C D~ counts in this African population. Neu~terin appears to be more sensitive for the clinical evaluat ion 0 :' the patients in this study. Hemoglobin might only be useful as a progression marker in male indi viduals .

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Immune activation is a dominant factor in the pathogenesis of African AIDS

Cited by 346 publications

References 43 publications

Immune dysregulation to Ethiopian immigrants in Israel: relevance to helminth infections?

Immune dysregulation to Ethiopian immigrants in Israel: relevance to helminth infections?

Reduced naive and increased activated CD4 and CD8 cells in healthy adult Ethiopians compared with their Dutch counterparts

Neopterin and other indicators of HIV progression in Zambian adults

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