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HIV and co-infections |
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| Authors: | Christina C. Chang Megan Crane JingLing Zhou Michael Mina Jeffrey J. Post Barbara A. Cameron Andrew R. Lloyd Anthony Jaworowski Martyn A. French Sharon R. Lewin |
| Affiliation: | 1. Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia Center for Biomedicine, Burnet Institute, Melbourne, Australia;2. Center for Biomedicine, Burnet Institute, Melbourne, Australia;3. Inflammation and Infection Research Centre, University of New South Wales, Sydney, Australia;4. Department of Infectious Diseases, Prince of Wales Hospital, Randwick, Australia Prince of Wales Clinical School, University of New South Wales, Randwick, Australia;5. Inflammation and Infection Research Centre, University of New South Wales, Sydney, Australia Prince of Wales Clinical School, University of New South Wales, Randwick, Australia;6. Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia Center for Biomedicine, Burnet Institute, Melbourne, Australia Department of Immunology, Monash University, Melbourne, Australia;7. School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia Department of Clinical Immunology, Royal Perth Hospital and PathWest Laboratory Medicine, Perth, Australia;8. Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia Center for Biomedicine, Burnet Institute, Melbourne, Australia Correspondence to: Sharon R. Lewin Department of Infectious Disease Alfred Hospital, Monash University Tel.: +613 9076 8491 Fax: +613 9076 2431 e-mail: sharon.lewin@monash.edu |
| Abstract: | Despite significant reductions in morbidity and mortality secondary to availability of effective combination anti-retroviral therapy (cART), human immunodeficiency virus (HIV) infection still accounts for 1.5 million deaths annually. The majority of deaths occur in sub-Saharan Africa where rates of opportunistic co-infections are disproportionately high. In this review, we discuss the immunopathogenesis of five common infections that cause significant morbidity in HIV-infected patients globally. These include co-infection with Mycobacterium tuberculosis, Cryptococcus neoformans, hepatitis B virus, hepatitis C virus, and Plasmodium falciparum. Specifically, we review the natural history of each co-infection in the setting of HIV, the specific immune defects induced by HIV, the effects of cART on the immune response to the co-infection, the pathogenesis of immune restoration disease (IRD) associated with each infection, and advances in the areas of prevention of each co-infection via vaccination. Finally, we discuss the opportunities and gaps in knowledge for future research. |
| Keywords: | HIV immunology tuberculosis cryptococcosis hepatitis B hepatitis C malaria immune restoration disease |