Newsgroup: it.salute.aids
Titolo: Qualcuno me lo spiega?

Ammetto di essere ignorante e non sapere l'inglese... però, in questo caso,
anche con l'italiano perdo dei colpi... che sia già già un sintomo di
demenza aids-correlata????
Se qualcuno me lo spiega e continuo a non capire... corro a farmi vedere!!!!
Magari posso chiedere l'invalidità.
Ciao a tutti
Luca
P.S. Qualche settimana fa ho perfino scordato il codice segreto del
bancomat. Risultato? Carrello pieno-cassa bloccata-quelli della fila che
ancora un po' mi linciavano!  :-((   TERIBILE!
___________________________________________________________________
Dalle ultime notizie di Nadir:
AIDS: Trovata una correlazione tra la fase acuta della patologia e tra la
progressione della fase cronica
 Lo si sospettava da tempo: dopo l'infezione primaria, il lento abbassamento
del virus è fortemente predittivo della progressione verso l'AIDS
Il fattore predittivo di quanto velocemente una persona progredirà verso
l'AIDS dopo l'infezione è la velocità con la quale la persona raggiunge il
set point virale dopo l'infezione acuta o primaria. Il set point virale è il
livello della carica virale nel periodo tra l'infezione primaria, dove non
esiste controllo del sistema immunitario sull'HIV e la carica virale si
attesta sul milione di copie e la fase finale in cui la carica virale
cresce, i CD4 calano e quindi è necessario l'intervento della terapia.
Avere inoltre almeno 7 sintomi HIV-correlati durante i primi 4 o 5 mesi
dell'infezione è predittivo di una più lenta progressione verso l'AIDS.
Ecco i dettagli in inglese:
This tends to be a 'steady state' in individuals because it represents a
delicate balance between the body mounting a sufficiently strong immune
response to control HIV and mounting one so strong that there are more
activated T-cells in which the virus can replicate.
Viral load 'set points' in individuals range from undetectable to several
hundred thousand, and it has been theorised that the size of the set-point
viral load is correlated with the speed of progression to Aids; that is, the
higher the set-point figure, the shorter the time that set point can be
maintained.
However researchers from the Institute of Human Virology in Baltimore, USA
and from Port of Spain in Trinidad have found that the speed with which the
person reaches the set point is an even stronger predictor of progression.
Twenty-two individuals identified in primary HIV infection from the Trinidad
Seroconverter Cohort were studied and followed for seven years. During this
time 45% developed AIDS, using the US Centers for Disease Control definition
(i.e. a CD4 count under 200 cells/mm3 and/or AIDS-defining symptoms).
Antiretrovirals became available during the study period but as they were
not given to subjects with CD4 counts over 200 cells/mm3 this did not
confound the study results.
The patients' eventual 'set point' predicted how quickly they would develop
Aids. All individuals with a set-point viral load over the median figure of
25,000 copies/ml had progressed to AIDS within 4.5 years of infection. In
contrast half the patients with viral loads under 25,000 copies/ml, or a
quarter of the total, had still not progressed to AIDS after seven years.
But the rate of viral load decline from the acute infection peak was even
more strongly predictive of progression to AIDS. The median viral load
decline following acute infection declined fourfold (0.63 log) every month,
meaning that the median set-point viral load of 25,000 copies/ml would be
achieved three to four months after acute infection.
All eleven patients who had a slower viral load decline than this had
progressed to AIDS within five years of infection. In contrast only
one-quarter of the patients whose viral load decline was faster had
progressed to AIDS by the end of the seven-year study.
In univariate analysis, fast initial clearance of HIV and a set-point that
was maintained for more than 20 months were both associated with a tenfold
lower likelihood of progressing to AIDS, while having a set-point viral load
of over 25,000 copies/ml was associated with 6.4 times the likelihood of
progression.
In multivariate analysis, a high rate of initial clearance of HIV was
consistently associated with a tenfold lower likelihood of progression,
regardless of the set-point viral load or CD4 count of subjects. In contrast
a low viral set-point was not a statistically significant predictor of
progression to AIDS in the absence of fast clearance after acute infection.
The strongest immune correlate of fast viral clearance after infection was
the total CD4 count during that initial clearance, suggesting that a robust
immune response to HIV is crucial in suppressing the initial bust of HIV
replication. However a strong anti-HIV CD8 response during chronic infection
predicted faster progression.
Probably for this reason patients with faster clearance rates of HIV after
acute infection were more likely to complain of 'viral' symptoms such as
fever, fatigue, headache, muscle aches and night sweats during acute
infection. In contrast, other studies have shown that people who complain of
these symptoms during chronic infection are faster progressors.
The researchers comment: "a down modulation of CD8 activation during steady
state may involve different immune effector mechanisms such as the Th2
response" - meaning that whereas generalised immune activation is 'good'
during acute infection, it is better to have high circulating levels of
cytokines such as IL-2 that actually dampen down the immune response during
chronic infection and ensure fewer T-cells get activated.
The researchers also found that in this Caribbean cohort, the overall
average time from infection to AIDS was shorter than that reported from
European and US cohorts, despite a similar average viral load. This
generally shorter time, which has also been observed recently in Thailand,
may reflect generally lower CD4
Reference
Blattner W et al. Rapid clearance of virus after acute HIV-1 infection:
correlates of risk of AIDS. Journal of Infectious Diseases 189 (May 15,
online advance publication).

these symptoms during chronic infection are faster progressors.
Spero di averti chiarito un po' le idee!!  :-)
Saluti!
G. Paraninfo
http://www.infettivibrescia.it

 G. Paraninfo
Grazie per le dritte... e la traduzione; ho capito!
credevo di essere più grave.
Per l'invalidità dovrò aspettare!!
:-)
Luca