An interesting vicious cycle occurs. Infection, which depends on the expression of chemokine receptors, which in turn is enhanced by immune activation, which the current paradigm dictates is determined by the degree of infection. Chemokine receptor expression increases as disease markers progress.
CXCR4 and CCR5 expression was enhanced on CD4+ T cells and correlated with HIV viral load and T cell activation. This enhancement is possibly a consequence of continuous immune activation and may contribute to HIV disease progression.