“…72 HIV strategies to protect lymphocytes from apoptosis include: (1) the upregulation of Bcl-2 and downmodulation of Bax by Vpr; 81 (2) the promotion of cell cycle progression, and subsequent increased virus production, by Tat-dependent inhibition of p53 transcription; 82 (3) the downregulation by Nef and gp120 of expression of the CD4 receptor by infected cells, thereby preventing subsequent gp120-CD4-mediated apoptosis; [83][84][85] and (4) the downmodulation by Vpu and Nef of the expression of MHC class I molecules and the upregulation of CD95L expression on infected cells, a strategy that might function to protect infected cells from cytolysis by CTL or NK cells. 86,87 These in vitro data are in line with in vivo observations showing that, in lymph-node biopsies from HIV-infected humans and SIV-infected monkeys, productively infected cells are not apoptotic, indicating that they are relatively resistant to direct HIV-induced killing in vivo. 31 Collectively, these data indicate that HIV can manipulate cellular apoptotic machinery, destroying the immune system through the activation of apoptotic programs in lymphocytes, but ensuring viral survival by manipulating the apoptotic machinery to its advantage in infected cells.…”