48.5 The immune system can be defeated.

T Cell Destruction: AIDS One mechanism for defeating the vertebrate immune system is to attack theh immune mechanism itself. Many helper T cells and inducer. T cells are CD+4 T cells. Therefore any pathogen that inactivates CD+4 T cells leaves the immune system unable to mount a response to any foriagn antigen. Acquired immune deficiency syndrome(AIDS) is a deadly disease for just this reason. The AIDS retrovirus, called human immunodeficiency virus(HIV), mounts a direct attack on CD+4 T cells because it recognizes the CD4 coreceptors associated with these cells. HIV is dicussed in detail in chapter 26. HIVs attack on CD+4 T cells cripples the immune system in at least three ways. First, HIV-infected cells die only after releasing replicated viruses that infect other CD+4 T cells, until the entire population of CD+4 T cells is destroyed (figure 48.23). In a normal individual, CD+4 T cells make up 60 to 80% of circulating T cells; in AIDS patients, CD+4 T cells often become too rare to detect (figure48.24). Second, HIV causes infected CD+4 T cells to secrete a soluble suppressing factor that blocks other T cells from responding to the HIV antigen. Finally, HIV may block transcription of MHC genes, hindering the recognition and destruction of infected CD+4 T cells and thus protecting those cells from any remaining vestiges of the immune system. The combined effect of these responses to HIV infection is to wipe out the human defense. With no defense against infection, any of a variety of otherwise commonplace infections proves fatal. With no ability to recognize and destroy cancer cells when they arise, death by cancer becomes far more likely. Indeed, AIDS was first recognized as a disease because of a cluster of cases of an unusually rare form of cancer. More AIDS victims die of cancer than from any other cause. Although HIV became a human disease vector only recently, possibly through transmission to humans from chimpanzees in central Africa. AIDS is already clearly one of the most serious diseases in human history (figure48.25). the fatality rate of AIDS is 100%; no patient exhibiting the symptoms of AIDS has ever been known to survive more than a few years without treatment. Aggressive treatmants can prolong life, but how much longer has not been determined. However, the disease is not highly contagious, because it is transmitted from one individual to another through the transfer of internal body fluids, typically semen and blood. Not all individuals exposed to HIV (as judged by the presence of anti-HIV antibodies in their blood) have yet acquired the disease. HIV-positive who have not fully exhibited AIDS symptoms can be more effectively treated with drugs. Until recently, the only effective way to slow the progression of the disease involved treatment with drugs