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634

BRAGDON v. ABBOTT

Opinion of the Court

virus invades different cells in the blood and in body tissues.
Certain white blood cells, known as helper T-lymphocytes or
CD4‘ cells, are particularly vulnerable to HIV. The virus
attaches to the CD4 receptor site of the target cell and fuses
its membrane to the cell’s membrane. HIV is a retrovirus,
which means it uses an enzyme to convert its own genetic
material into a form indistinguishable from the genetic mate-
rial of the target cell. The virus’ genetic material migrates
to the cell’s nucleus and becomes integrated with the cell’s
chromosomes. Once integrated, the virus can use the cell’s
own genetic machinery to replicate itself. Additional copies
of the virus are released into the body and infect other cells
in turn. Young, The Replication Cycle of HIV–1, in The
AIDS Knowledge Base, pp. 3.1–2 to 3.1–7 (P. Cohen, M.
Sande, & P. Volberding eds., 2d ed. 1994) (hereinafter AIDS
Knowledge Base); Folks & Hart, The Life Cycle of Human
Immunodeﬁciency Virus Type 1, in AIDS: Etiology, Diagno-
sis, Treatment and Prevention 29–39 (V. DeVita et al. eds.,
4th ed. 1997) (hereinafter AIDS: Etiology); Greene, Molecu-
lar Insights into HIV–1 Infection, in The Medical Manage-
ment of AIDS 18–24 (M. Sande & P. Volberding eds., 5th
ed. 1997) (hereinafter Medical Management of AIDS). Al-
though the body does produce antibodies to combat HIV in-
fection, the antibodies are not effective in eliminating the
virus. Pantaleo et al., Immunopathogenesis of Human Im-
munodeﬁciency Virus Infection, in AIDS: Etiology 79; Gard-
ner, HIV Vaccine Development, in AIDS Knowledge Base
3.6–5; Haynes, Immune Responses to Human Immunodeﬁ-
ciency Virus Infection, in AIDS: Etiology 91.

The virus eventually kills the infected host cell. CD4‘
cells play a critical role in coordinating the body’s immune
response system, and the decline in their number causes
corresponding deterioration of the body’s ability to ﬁght in-
fections from many sources. Tracking the infected individu-
al’s CD4‘ cell count is one of the most accurate measures of
the course of the disease. Greene, Medical Management of