What would you predict might happen to the course of the HIV infection in a person who developed toxic shock syndrome while in the latent phase of HIV? Explain your answer
What will be an ideal response?
Toxic shock syndrome is caused when superantigens, such as toxic shock syndrome toxin-1 (TSST-1) produced by some strains of Staphylococcus, nonspecifically activate large numbers of CD4 T cells. When a T cell is activated, the transcription factor NFκB is activated and switches on genes involved in the normal T-cell response. However, NFκB can also bind to the promoter of the HIV provirus to initiate its transcription and subsequent viral replication. Thus, if a T cell activated during toxic shock coincidentally contains an HIV provirus, NFκB will initiate the replication of HIV and the cell will die. If a significant proportion of the person's T cells harbor the provirus, one would predict widespread reactivation of the virus and a sharp rise in the amount of HIV in the blood (viremia) after the onset of toxic shock.
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