The immune system in overdrive

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The first picture is about an idea.

A dog chasing its own tail represents your immune system if you are HIV positive and not taking ART.

Continuous HIV replication burns up energy. Your immune system eventually becomes worn down and exhausted.

When not on ART, your body produces CD4 cells to fight the infection. But HIV uses these cells to make more virus. In response, the immune system makes more CD4 cells – continuing the overactived cycle.

Over time, for most people, the immune system loses – even though this might take many years. When viral load is detectable, your immune system is in overdrive. It is burns up energy and becomes exhausted.

The increased activity is called immune activation or immune inflammation. 

It increases the risk of serious illnesses that were not previously linked to HIV. This includes a higher risk of heart disease, stroke, liver and kidney disease and some cancers.

For the last 15 years doctors have become more worried about immune activation when not on ART.

After ART reduces viral load to undetectable levels, nearly all of this overactivation stops. Your immune system gets a chance to rest and repair itself, and your CD4 count can recover.

Last updated: 1 April 2022.