Table 2.

CLINICAL AND IMMUNOLOGIC ASPECTS OF HIV DISEASE

	Clinical Manifestations	Systemic Immune Function	Mucosal Immune Function
Early events	Acute febrile illness or asymptomatic infection	Infection of CD4+ lymphocytes with possible decrease in CD4 T-lymphocyte number	Infection of T cells and possibly macrophages in the lymphoid aggregates
Intermediate events	Altered body composition; lactase deficiency; bacterial overgrowth; malabsorption; Candida esophagitis; abnormal growth	Decreased CD4+ T-cell number, NK activity, cytotoxic T-cell activity, B-cell and macrophage number	Increased CD8+ and decreased CD4+ T lymphocytes in the lamina propria; decreased lgA secretion;extensive HIV-1 trapping in lymphoid aggregates
Late events	Malnutrition; enteric infection (cytomegalovirus, Mycobacterium avium intracellulare, cryptosporidium, adenovirus, and other opportunistic infections); malignancy	Decreased B-cell, T-cell, and monocyte/ macrophage function	Decrease in lamina propria lymphoid elements; breakdown in mucosal lymphoid aggregate structure with release of HIV- 1 from follicular dendritic cells