Mononuclear Phagocytes as Targets, Tissue Reservoirs, and Immunoregulatory Cells in Human Immunodeficiency Virus Disease

  • M. S. Meltzer
  • H. E. Gendelman
Part of the Current Topics in Microbiology and Immunology book series (CT MICROBIOLOGY, volume 181)


Infection by the human immunodeficiency virus (HIV) initiates a slowly progressive degenerative disease of the immune system termed the acquired immunodeficiency syndrome (AIDS). The primary immunologic defect in AIDS is an inexorable depletion of CD4+ T cells, a depletion invariably associated with opportunistic infection, degenerative neurologic disease, a variety of neoplastic changes, and ultimately death (Lifson et al. 1988). The fequency of infected cells in blood of asymptomatic HIV-seropositive subjects, as detected by polymerase chain reaction gene amplification of DNA from leukocyte lysates or by direct isolation of HIV from limiting dilutions of blood leukocytes, is about 1 in 40000 (0.0025%). This frequency increases about 1000-fold in patients with symptomatic disease: AIDS-related complex (ARC) and AIDS (Schnittman et al. 1989; Psallidopoulos et al. 1989; Ho et al. 1989a). Studies further show that virtually all infected blood leukocytes throughout HIV disease are CD4+ T cells (Schnittman et al. 1989; Psallidopoulos et al. 1989). Indeed, in late-stage disease about 1 in 40 CD4+ T cells harbor virus. Attempts to detect viral protein or mRNA in blood leukocytes of seropositive patients, however, reveal a frequency of productively infected cells in early or late disease of no more than 0.001% (Harper et al. 1986). Thus, >99% of infected T cells are latently infected. But T cells are not the only target cell for HIV. In certain bodily tissues, such as those of the central nervous system, lymph nodes, or lung, the frequency of cells productively infected with HIV may be 10000-fold higher than that in blood. In each of these tissues, the predominant cell type infected with HIV and producing virus is not the CD4+ T cell, but rather the macrophage (for reviews see Gendelman et al. 1989; Meltzer et al. 1990).


Human Immunodeficiency Virus Macrophage Colony Stimulate Factor Acquire Immunodeficiency Syndrome Mononuclear Phagocyte Human Immunodeficiency Virus Disease 
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© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • M. S. Meltzer
    • 1
  • H. E. Gendelman
    • 1
  1. 1.HIV Immunopathogenesis Program, Department of Cellular ImmunologyWalter Reed Army Institute of ResearchUSA

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