During the last 5 years, major advances have been made in our understanding of the pathogenesis of human immunodeficiency virus (HIV) disease and in the development of new potent antiviral agents. With regard to HIV pathogenesis, several recent observations have not only changed our perspectives of HIV disease, but have been critical for the design of therapeutic strategies. These oberservations include: 1. The delineation of the virologic and immunologic events associated with primary HIV infection. 2. The development of highly sensitive molecular techniques including polymerase chain reaction (PCR) assays for the determination of HIV RNA in plasma, together with the identification of lymphoid tissue as the primary anatomic site for HIV replication and spreading. 3. The characterization of the dynamics of HIV infection. 4. The identification of chemokines with suppressor activity on HIV replication and the discovery of co-receptor molecules for HIV entry.
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