Living in oblivion: HIV immune evasion

The human and simian immunodeficiency viruses (HIV and SIV, respectively) are members of the lentiviridae subgroup of retroviruses that cause a progressive failure of the host immunological functions culminating in the clinical collapse known as AIDS, or acquired immunodeficiency syndrome. In the absence of antiviral therapy, this course is inexorable in spite of an initially vigorous immune response. Two fundamental characteristics of the biology of primate lentiviruses explain this apparent paradox. First, HIV and SIV infect CD4(+) targets such as helper T lymphocytes and macrophages, that is, cells that normally play an essential role in the emergence and maintenance of an effective antiviral response. Second, these viruses have evolved a number of strategies to evade control by the immune system. These include mutational escape, latency, masking of antibody-binding sites on the viral envelope, downmodulation of the class I major histocompatibility complex (MHC-I), and upregulation of the Fas ligand on the surface of infected cells. Examining the mechanisms of these phenomena not only helps to understand how HIV wins its war against the immune system, but it also suggests as yet unexploited avenues to combat the virus through therapies and to develop a vaccine.