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HIV and co-infections

Authors

  • Christina C. Chang,

    1. Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia
    2. Center for Biomedicine, Burnet Institute, Melbourne, Australia
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  • Megan Crane,

    1. Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia
    2. Center for Biomedicine, Burnet Institute, Melbourne, Australia
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  • JingLing Zhou,

    1. Center for Biomedicine, Burnet Institute, Melbourne, Australia
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  • Michael Mina,

    1. Inflammation and Infection Research Centre, University of New South Wales, Sydney, Australia
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  • Jeffrey J. Post,

    1. Department of Infectious Diseases, Prince of Wales Hospital, Randwick, Australia
    2. Prince of Wales Clinical School, University of New South Wales, Randwick, Australia
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  • Barbara A. Cameron,

    1. Inflammation and Infection Research Centre, University of New South Wales, Sydney, Australia
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  • Andrew R. Lloyd,

    1. Inflammation and Infection Research Centre, University of New South Wales, Sydney, Australia
    2. Prince of Wales Clinical School, University of New South Wales, Randwick, Australia
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  • Anthony Jaworowski,

    1. Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia
    2. Center for Biomedicine, Burnet Institute, Melbourne, Australia
    3. Department of Immunology, Monash University, Melbourne, Australia
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  • Martyn A. French,

    1. School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia
    2. Department of Clinical Immunology, Royal Perth Hospital and PathWest Laboratory Medicine, Perth, Australia
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  • Sharon R. Lewin

    Corresponding author
    1. Center for Biomedicine, Burnet Institute, Melbourne, Australia
    • Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia
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Correspondence to:

Sharon R. Lewin

Department of Infectious Disease

Alfred Hospital, Monash University

Tel.: +613 9076 8491

Fax: +613 9076 2431

e-mail: sharon.lewin@monash.edu

Summary

Despite significant reductions in morbidity and mortality secondary to availability of effective combination anti-retroviral therapy (cART), human immunodeficiency virus (HIV) infection still accounts for 1.5 million deaths annually. The majority of deaths occur in sub-Saharan Africa where rates of opportunistic co-infections are disproportionately high. In this review, we discuss the immunopathogenesis of five common infections that cause significant morbidity in HIV-infected patients globally. These include co-infection with Mycobacterium tuberculosis, Cryptococcus neoformans, hepatitis B virus, hepatitis C virus, and Plasmodium falciparum. Specifically, we review the natural history of each co-infection in the setting of HIV, the specific immune defects induced by HIV, the effects of cART on the immune response to the co-infection, the pathogenesis of immune restoration disease (IRD) associated with each infection, and advances in the areas of prevention of each co-infection via vaccination. Finally, we discuss the opportunities and gaps in knowledge for future research.

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