It is more remarkable to note that co-infected patient reported in this study represented with a weak immune system, being a one-year-old leukemia patient, thus suggesting that, in fact, immunological state of the patient may play an important role in the establishment of coinfection.
In fact, recent immunological analyses have shown that, unlike individuals with mild and severe non-cerebral malaria, CM patients present elevated levels of a specific cluster of cytokines, which include TGF-β, TNF-α, IL-1β and IL-10 [16].
The clonal deletion of auto-reactive thymocytes in this process (negative selection) is one way to achieve tolerance and is supposed to be the major mechanism of immunological tolerance, given the fact that mice and humans deficient for the transcriptional regulator AIRE show an impaired clonal deletion in the thymus and suffer from multiorgan autoimmune disease [1], [2], [3], [4].
To accommodate for the fact that immunological criteria for severe HIV immunodeficiency were age-specific, we created a categorical variable describing the presence of severe immunodeficiency according to the WHO 2006 criteria (18 35 months: <20% CD4% or <750 countount; 36 59 months: <15% CD4% or <350 countount; ≥ 59 months: <15% CD4% or <200 countount).
While some studies have included patients with genotypes-2 and -3 infection, interpretation of these studies is confounded by the fact that immunological assays have relied almost entirely on genotype-1 peptides that do not represent the autologous circulating virus infection within the host.
The BTB provides in fact an immunological barrier to the developing male germ cells: it sequesters postmeiotic germ cells from the systemic circulation, thus preventing the production by the host of antibodies against spermatid-specific antigens whose expression is restricted to spermiogenesis only [ 20].
Disparate results in genotype-1 infection may be accounted for by technical challenges such as weak T cell responses at the detection limit of immunological assays, and the fact that peptides have been used in assays that do not reflect the circulating viral strain.
Following demonstration of the efficacy of TNF inhibitors in rheumatoid arthritis many rheumatologists were surprised when they were also shown to be effective in ankylosing spondylitis and psoriatic arthritis, given the different clinical and radiological features of these disorders and the fact that different immunological pathways appeared to be involved.
The fact that an immunological reaction to a single short peptide of ubiquitously expressed protein causes polyarthritis provides new insight to the understanding of autoimmune arthritis.
The cutoff level of 200 cells/μLs/μL was emphasized in the analysis of immunological recovery, based on the fact that it was the WHO reference for initiating HAART at the time of the study.
