We have considered factors that predispose to infection by the human immunodeficiency virus as well as the clinical consequences of infection. We have also reviewed what is known about the virological status of the asymptomatic carrier, particularly the female, and the fact that pregnancy may be a cofactor for progression of HIV disease in seropositive women. Additionally, we have discussed several other cofactors that may promote the progression of HIV infection. These include intercurrent infection, excessive use of recreational drugs and alcohol, malnutrition, and stress. With respect to stress, we have reviewed evidence indicating that certain personality factors, by buffering the effects of stress, may play a role in determining the outcome of HIV disease. Possible neuromodulators that may mediate the effect(s) of stress on the immune system are considered. Also discussed is the potentially complicating role of HIV infection of the brain of asymptomatic carriers on psychosocial studies, as well as the possible dysregulation of neuromodulator levels which might result from such infection. The possibility that HIV infection of the brain may act to enhance progression of HIV infection is proposed.
Black, Paul H. and Levy, Elinor M.
"The HIV Seropositive State and Progression to AIDS: An Overview of Factors Promoting Progression,"
New England Journal of Public Policy:
1, Article 9.
Available at: http://scholarworks.umb.edu/nejpp/vol4/iss1/9