⚠️🚩Long COVID is not AIDS: why this comparison confuses more than it clarifies Following the huge debate that has emerged around this topic, I’m going to explain in more detail why Long COVID, ME/CFS, and AIDS are not the same thing, even if they may share some superficial immunological features. Mega thread 🧵 I’ve been seeing comparisons between Long COVID, ME/CFS, and HIV/AIDS for quite some time. I understand where they come from: chronicity, immune dysfunction, T-cell exhaustion, viral reactivations, persistent inflammation. All of that exists. But the problem is that sharing downstream immunological features does not mean we are dealing with the same biology, the same clinical trajectory, or the same type of immunodeficiency. That is where the comparison breaks down. And yes, to be rigorous, it should be stated properly: HIV is the virus and AIDS is the acquired immunodeficiency syndrome to which untreated HIV infection progresses. But precisely because so many people on social media use “HIV” when what they really mean is the immunodeficiency state caused by CD4 depletion, it is worth clarifying why Long COVID and ME/CFS do not behave like AIDS, even if they may share some features of chronic immune dysfunction. The main difference is this: in untreated HIV infection, the dominant axis of the disease is the progressive destruction and numerical depletion of CD4 lymphocytes, eventually leading to AIDS, which is defined, among other things, by a CD4 count below 200 cells/µL or by stage 3-defining illnesses. That progression leads to a classical, structural acquired immunodeficiency, with real loss of the CD4 compartment. By contrast, in Long COVID and in many cases of post-infectious ME/CFS, the dominant pattern appears to be different: antigen persistence or sustained antigenic stimulation, chronic immune activation, altered inflammatory pathways, exhaustion signatures, immune dysfunction, and, in an important subgroup, autoimmunity. In other words, immunodeficiency may be present, but it is often a functional immunodeficiency due to exhaustion and dysregulation, not an immunodeficiency whose central axis is the massive destruction of the CD4 compartment. This is not a simple copy of HIV; it is a different type of immunopathological chronicity. The first major difference is temporal and clinical. In HIV infection, there is often an initial phase that is relatively nonspecific or even asymptomatic, and the major consequences appear later, as CD4 depletion progresses. In Long COVID and ME/CFS, symptoms usually appear immediately or shortly after the triggering infection. That difference alone should already make us cautious about the comparison. From that perspective, Long COVID and ME/CFS resemble a kind of chronic infectious mononucleosis-like state much more than AIDS. And that matters a lot immunologically. Infectious mononucleosis caused by EBV is characterized by a marked expansion of mononuclear cells, especially CD8 T lymphocytes, and by an intense inflammatory response. In that context, IFN-γ rises, the antigen-presentation machinery is amplified, and an environment is created in which CD4 cells are not disappearing, but rather actively participating in the response. Precisely for that reason, EBV infectious mononucleosis has been linked to a higher later risk of autoimmune diseases and to the pathogenesis of multiple sclerosis. Continued in the next post ⬇️ 1/

A cruise (several days or weeks eating and socializing in confined spaces) is arguably much worse than a birthday party. So why would you expect only transmission via close contact and tell fellow cruise passengers that they are at low risk? x.com/Ayjchan/status/2054902…

CC community: please keep your ableism and sanism in check while discussing the hantavirus situation. If you could even just pretend to be in community with disabled people for a little while that would be great. Thanks!

There is literally nothing to worry about, calm down. x.com/KenDBerryMD/status/205…