2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

An Important Clue from Nature

Rhesus Macaque • Infect with SIV • High Levels of Viral Replication • AIDS and death

Sooty Mangabey • Infect with SIV • High Levels of Viral Replication • No AIDS, normal lifespan

• Massive Immune Activation

• Minimal Immune Activation

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Inflammation Can Cause Lymphoid Tissue Fibrosis

• Associated with low %naïve T cells and poor CD4 + T cell recovery

• May impair functional immune responses

Estes, JID, 2008; Schacker, JCI, 2002; Zeng, JCI, 2011

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High T Cell Activation Associated with Blunted CD4 Recovery

Hunt et al, JID, 2003 (see also Goicoechea, JID, 2006; Gandhi, JAIDS, 2006)

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