AIDS/HIV, Molecular and Cell Biology
111
Infection
Seroconversion
Death
Asymptomatic
Acute
HIV
syndrome
Advanced
HIV
disease
CD4
+
lymphocyte count
Anti-gp120 antibodies
HIV-specific CIL
Viraemia
Anti-p24
antibodies
1234
Months after infection
Years
56
Fig. 7
Natural history of HIV infection.
half of infected patients will have symp-
toms resembling a glandular feverlike
illness with lymphadenopathy, transient
petechial rashes, arthropathy, evidence of
peripheral neuropathy, and occasionally a
brief meningoencephalitic illness. How-
ever, virtually without exception, these
symptoms resolve. There then follows a
period of apparent stability in which the
viral level or ‘‘viral load’’ remains sta-
ble and there is ongoing evidence of an
immune response. In some individuals,
persistent enlargement of lymph nodes
occurs associated with weight loss and
fevers. This so-called
persistent generalized
lymphadenopathy
appears to be associated
with a worse prognosis in terms of the
speed of onset of immunodeFciency. De-
spite the asymptomatic nature of infection
in most individuals at this stage, mea-
surements of the CD4 lymphocyte count
show that during the initial viral peak,
there is a corresponding trough in lym-
phocyte numbers, implying a signiFcant
amount of direct virus mediated lympho-
cyte destruction. This rises again as the
virus load is brought under control but
does not achieve the preinfection level and
previous page 111 Encyclopedia of Molecular Cell Biology and Molecular Medicine read online next page 113 Encyclopedia of Molecular Cell Biology and Molecular Medicine read online Home Toggle text on/off