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Lorin Peck
Dan Thomas
Biology 1615
10 November 2014
Disentangling Human Tolerance and Resistance Against HIV Summary
HIV has existed in the USA for more then two decades. The First case of HIV in the US
was reported from a flight attendant in 1981. The flight attendant was gay so everyone around
that time period thought that it was only gay people that were infected, because he infected
numerous another gay men in the state. That is a very wrong assumption, because HIV can be
on the surfaces you touch on a daily bases, for example: On toilet seats, water fountains, or even
using a utensil that a person with HIV has used. HIV is everywhere, and most people wouldnt
even know it or think about it on a daily bases.
Human tolerance against HIV is characterized as reduced pathogenesis despite high
pathogen load. The Swiss HIV Cohort study used data to analyze the variation of tolerance in
HIV. In this study they test the tolerance and alleles of the Human Leukocyte Antigen or called
HLA genes, age, and their sex. The HLA found out that the alleles that have better HIV control
do not benefit the tolerance. This study also showed them that the people that are 20 to 60 years
old are more prone to get infected with HIV, because of the pathogen load in their bodies.
Human resistance against HIV is more common, because most peoples bodies cannot
handle the load of pathogens. The host can either deal to fight them or learn to deal with them.
The HIV resistance can differ depending on the persons genetic information in the body. In the
Swiss HIV Cohort study they found that the individuals that carry two different alleles of HLA
are an important immunity gene, are more tolerant and are less likely to resist the HIV. The

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resistance mechanisms reduce the pathogen burden. The evolution of resistance genes host
counter adaptations of the pathogen that overcome host resistance, results in an endless arms
race.
Once HIV is identified as tolerance or resistance it can be exploited with therapy. The
tolerance resistance therapy is not based on reducing the pathogen load; it is aimed to assure the
well being of the host. This is a result in the pathogen population evolving in higher virulence.
It is becoming more obvious and recognized that disentangling and tolerance not only advances
the understanding of coevolution between hosts and pathogens, but also is relevant clinically.
The formal framework for disentangling tolerance and resistance has not been applied to many
animal disease systems. There was a paradigmatic study done on a mouse and also a few insects,
but a tolerance analysis has not yet been conducted for any clinically relevant human diseases.
In the study they apply an analysis to HIV infection in humans.
As a result in the Swiss study they determined set point viral loads and CD4+ T-cell
declines in 3,036 HIV infected individuals. The Swiss study investigated the tolerance of
humans against HIV, they determined that the relationship between CD4+ T-cells decline and set
point viral load in their study of population. The study started by establishing the relation for the
entire study population. This relation is a baseline against the relationships between CD4+ Tcell decline and the set point viral load in specific subgroups. In this study they also investigated
the tolerance that analyzes HLA-B, which is heterozygotes. They found that certain HLA-B
alleles cause the disease to progress more rapidly without increasing the viral load by modulating
immunopathology, rather then leading to the killing of infected cells. The higher the tolerance
and the younger the age of someone who is infected, it is more likely that they have had a loss of
CD4+ T-cells.