Acute HIV-1 Infection: Translating Pathogenesis into
Opportunity
Eric Rosenberg
Massachusetts General Hospital
Harvard Medical School
Since the advent of highly active antiviral therapy (ARV), there has
been a dramatic decline in AIDS related illness and death. Although
therapy has transformed infection with HIV from a terminal illness to
a chronic disease, the prospect of taking antiretroviral therapy for
life is difficult for some and impossible for most. Therefore,
alternative strategies to augment host immune responses to control
viral replication and disease activity must be investigated.
One of the limiting factors in studying HIV/AIDS infection is that
current methods for designing and implementing clinical trials are
often based on expert opinion and "clinical intuition" and these
approaches typical fail to deliver clinically relevant answers. Our
hypothesis is that the design of clinical trials could be optimized
through the integration of biology with mathematical and statistical
modeling. The goal of this lecture will be to provide a "primer" for
understanding the biological, immunologic and virologic issues of HIV
infection followed by an explanation of our current modeling efforts.
The human immune response is highly successful at controlling invasion
by many microbes. However, in the case of HIV infection the immune
response is considered âpartially effectiveâ at best. During this
lecture I will shed insight into the different mechanisms responsible
for controlling HIV replication and to discuss possible opportunities
to translate what we know about viral pathogenesis into opportunities
for treatment. Specifically, we will focus on the setting of "Acute
HIV infection" as a biological system which has the potential to be
exploited.
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