nature insight: AIDS

AIDS
Vol. 410, No. 6831 (19 April 2001).
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Cover illustration
Progeny HIV particles (red) emerging from an infected T lymphocyte (green) showing how many progeny can be generated in a single infected cell.
(Image provided by D. Hockley/NIBSC/SPL.)

The scale of the human immunodeficiency virus (HIV) epidemic is far greater than was predicted a decade ago. Already almost 20 million people have died of AIDS, over 30 million are currently living with HIV, and 16,000 new infections occur daily. It is clear that methods aimed at controlling the spread of the virus are failing to do so. Existing AIDS therapies are out of reach for most HIV-infected people in developing countries and, where available, they are limited by their toxicity and their cost. Furthermore, it is becoming increasingly apparent that current drugs are unable to purge the body of the virus and that discontinuation of triple therapy leads to a rapid rebound of plasma viraemia. Development of an effective HIV vaccine therefore remains one of the most pressing challenges facing modern medicine, and new types of drugs to treat already established disease are needed urgently.

In this month's Nature Insight we examine the biology of the virus and the disease it causes. We begin with reviews focusing on the current status of the AIDS global pandemic, covering the incidence and patterns of infection, and the potential threat posed by the evolution of opportunistic infections in a growing proportion of immunocompromised people. The following two articles discuss the underlying causes for the progressive and relentless depletion of CD4⁺ T cells, and for the inability of cytotoxic T cells to control infection in the long term. We then focus on the molecular pathways that give rise to neuronal injury and apoptosis in HIV-associated dementia, followed by a comprehensive review of HIV chemotherapy. The final article reviews the scientific challenges facing HIV vaccine development.

We hope that both general readers as well as experts in the field will find these articles useful and informative.

Ursula Weiss Senior Editor