¹Human Immunology Section, Vaccine Research Center, National Institute of Allergy and infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA

Correspondence: DC Douek, (ddouek@mail.nih.gov)

Received 24 April 2007; Accepted 30 May 2007.

Abstract

There has recently been a resurgence of interest in the gastrointestinal pathology observed in patients infected with HIV. The gastrointestinal tract is a major site of HIV replication, which results in massive depletion of lamina propria CD4 T cells during acute infection. Highly active antiretroviral therapy leads to incomplete suppression of viral replication and substantially delayed and only partial restoration of gastrointestinal CD4 T cells. The gastrointestinal pathology associated with HIV infection comprises significant enteropathy with increased levels of inflammation and decreased levels of mucosal repair and regeneration. Assessment of gut mucosal immune system has provided novel directions for therapeutic interventions that modify the consequences of acute HIV infection.