Wednesday, 10 February 2016

HIV EXPOSED UNINFECTED; 4 reasons behind this phenomenon



INTRODUCTION

Talk about antibacterial therapy resistance and be sure you will not lose many minds in it. But this issue of HIV infection natural resistance still intrigues many scientific minds on the grounds that there is a small fraction of individual with natural resistance to HIV infection. This is still a subject under study to unleash more facts and aid in the fight against HIV/AIDS. 

EXPOSED SERONEGATIVE


An exposure to AIDS causing virus results to HIV infection in majority of the population but there is a small fraction of individuals in a population who despite inherently being exposed to the virus remain seronegative. These individuals are called ‘exposed seronegatives’ or ‘exposed uninfected.’

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Exposed uninfected is a phenomenon that have been observed to persist in commercial sex-workers, baby born to HIV seropositive mother, healthcare workers having incidental sharps injuries, having unprotected sexual contact with infected partner and hemophiliacs receiving HIV contaminated blood. 


There are several factors that may account for persistent exposed seronegatives which may include:-

  • Low risk of transmission through the exposed route e.g sexual contact route. This can happen in a case where the HIV infected person has a low level of the virus in the blood.. When HIV infected person is started on Highly Active Antiretroviral Therapy (HAART), viral replication is suppressed and viral load in the system goes low to even undetectable levels in some cases. This reduces the risk of HIV transmission.

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  • Genetic mutations of CCR5 delta 32.To simplify this point, HIV uses two receptor sites order to gain entry into the body cell. One of the receptor sites is in the immune cells CD4 cells and the other receptor site called CCR5. Not all HIV strains use CCR5 receptor site but more than 95% of HIV infection is caused by HIV strain that uses this receptor site. Genetic mutation of CCR5 delta 32 homozygous individuals lack functional CCR5 receptor site where HIV can attach and these individual are naturally not able to contract HIV.

  •  Individual body immunity has also been found to play key role for persistent exposed seronegatives. A cohort study contacted in Kenya, Nairobi among the commercial sex workers who were HIV seronegative found that the subjects had HIV specific CD8+ T lymphocytes in their genital mucous lining which was suggestive of constant exposure to HIV.
  • Elite controllers- these are people whose immune system is well equipped to attack and destroy AIDS causing virus-HIV. This is enhanced by Human Leukocyte Antigen. Studies have also indicated that ‘elite controllers’ infected with HIV may never express signs of the infection.
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References:
Immune to HIV:  How do they do it? Address: http://www.livescience.com/9983-immune-hiv.html
Natural resistance to HIV infection: Lessons learned from HIV-exposed uninfected individuals- The Journal of Infectious Diseases. Address: http://jid.oxfordjournals.org/content/202/Supplement_3/S345.full.
Resistance to HIV infection -NCBI. Address: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1539443/