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Overview of HIV

From the Departments of Psychology, Medicine and Microbiology/Immunology, University of Miami Miller School of Medicine, Miami, Florida.

Address correspondence and reprint requests to Nancy Klimas, University of Miami Miller School of Medicine, VA Medical Center, 1201 NW 16^th St Miami, FL. E-mail: NKlimas{at}med.miami.edu

This article provides an overview and reviews the HIV pandemic, the basic biology and immunology of the virus (e.g., genetic diversity of HIV and the viral life cycle), the phases of disease progression, modes of HIV transmission, HIV testing, immune response to the infection, and current therapeutic strategies. HIV is occurring in epidemic proportions, especially in Sub-Saharan Africa. In the US, men who have sex with men account for over half of AIDS diagnoses; racial and ethnic minorities are disproportionally affected. Factors influencing the progression and severity of HIV infection include type of immune response, coinfection (e.g., another sexually transmitted infection, including hepatitis B or C), age and behavioral and psychosocial factors. Antiretroviral therapies can achieve reduction in blood levels of the HIV virus below the limits of detection by current technology. However, effective treatment requires adherence to therapy. Patient failure to adhere to treatment regimens results in detectible circulating virus and in HIV disease progression, and is the primary cause of drug resistance. In addition to research on the immunology and virology of the disease, other studies focus on behavioral and psychosocial factors that may affect medication adherence and risk behaviors.

Key Words: HIV/AIDS • disease progression • immune response • treatment

Abbreviations: CDC = Centers for Disease Control and Prevention; PCP = Pneumocystis carinii pneumonia; HCV = hepatitis C virus; ART = antiretroviral treatment; HAART = highly active antiretroviral therapy.

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