Clinical immunology and HIV infection.

Clinical immunologists play a major role in the multidisciplinary approach to the management of human immunodeficiency virus (HIV) infection and its complications in Australia, through involvement with the clinical and laboratory management of patients as well as with research on disease pathogenic mechanisms. Consequently, immunological monitoring of the pathogenic effects of chronic HIV infection is commonplace, allowing for studies on the clinical utility of immunological investigations as a means of monitoring the severity of HIV-induced immunopathology and immunodeficiency to be undertaken. Such studies have demonstrated the clinical utility of CD4+ T-cell assays, but studies on cutaneous delayed-type hypersensitivity have demonstrated that the cellular immunodeficiency induced by chronic HIV infection may be more complex than CD4+ T-cell depletion alone. In addition, the involvement of clinical immunologists has greatly facilitated studies on the pathogenic mechanisms underlying HIV-induced immunopathology. Such activities place Australia in a very advantageous position for future studies on the use of immune-based therapies for controlling the pathogenic effects of chronic HIV infection.