Peter Benton , M.D. is a fictional character from the NBC medical drama series ER , portrayed by actor Eriq La Salle , appearing as a primary character from the pilot episode until part way through the eighth season .
115-481: La Salle made two guest appearances in later episodes of the eighth season, before returning again for two more episodes in the fifteenth season , including the series finale . Although Benton was an original character, according to an interview La Salle gave in 1997, he was cast late in the role, after the first season had already started filming. He recalled, "I was surprisingly calm. When casting waits that long, they're basically waiting for someone to come in and take
230-490: A long terminal repeat (LTR). Regions in the LTR act as switches to control production of new viruses and can be triggered by proteins from either HIV or the host cell. The Psi element is involved in viral genome packaging and recognized by gag and rev proteins. The SLIP element ( TTTTTT ) is involved in the frameshift in the gag - pol reading frame required to make functional pol . The term viral tropism refers to
345-608: A bit offensive if the negative things are all you're showing. Because in real life we romance and get on each other's nerves and laugh and do all the things that any other race of people do. So if the only time you show a balanced relationship is in an interracial relationship, whether it's conscious or sub-conscious, it sends a message I'm not comfortable with." Mindful of the image that he was portrayed on television, La Salle asked producers to end Benton's interracial romance. While being interviewed by Johnnie Cochran on Johnnie Cochran Tonight , La Salle commented, "We have to take care of
460-430: A bleeding aneurysm and keep a man alive until a qualified surgeon is available. Although he does this technically against regulations, he is supported after the fact by attending physician (and ER chief) David Morgenstern. In Season 1, we learn that Dr. Benton's mother has had a stroke and is mostly being cared for by his sister Jackie , who wants to move her into an assisted living facility , an option to which Peter
575-535: A cell by a virion can be called "cell-free spread" to distinguish it from a more recently recognized process called "cell-to-cell spread". In cell-free spread (see figure), virus particles bud from an infected T cell, enter the blood or extracellular fluid and then infect another T cell following a chance encounter. HIV can also disseminate by direct transmission from one cell to another by a process of cell-to-cell spread, for which two pathways have been described. Firstly, an infected T cell can transmit virus directly to
690-481: A cell surface. The unusual processing and high density means that almost all broadly neutralising antibodies that have so far been identified (from a subset of patients that have been infected for many months to years) bind to, or are adapted to cope with, these envelope glycans. The molecular structure of the viral spike has now been determined by X-ray crystallography and cryogenic electron microscopy . These advances in structural biology were made possible due to
805-731: A decision that caused him to clash with Benton. Nonetheless, the two have reconciled and, despite the fact that they have interacted less since Carter's transition to emergency medicine, formed a deep friendship. In Season 6, Benton was visibly concerned about Carter after he was stabbed by a schizophrenic patient and eventually operates on him along with Dr. Anspaugh. During the surgery, Benton has become protective of Carter and expresses reluctance to leave his former protégé for another patient. Soon after, upon hearing Carter becoming addicted to painkillers, he refuses to watch Carter self-destruct and convinces Carter to enter rehab . In Season 8, before Dr. Benton departs County General, his final farewell
920-414: A few tested specimens might provide inconclusive results because of a low quantity specimen. In these situations, a second specimen is collected and tested for HIV infection. Modern HIV testing is extremely accurate, when the window period is taken into consideration. A single screening test is correct more than 99% of the time. The chance of a false-positive result in a standard two-step testing protocol
1035-448: A human host cell when the newly formed virus particle buds from the cell. The viral envelope contains proteins from the host cell and relatively few copies of the HIV envelope protein, which consists of a cap made of three molecules known as glycoprotein (gp) 120 , and a stem consisting of three gp41 molecules that anchor the structure into the viral envelope. The envelope protein, encoded by
1150-568: A key step in the progression to AIDS. A number of studies with subtype B-infected individuals have determined that between 40 and 50 percent of AIDS patients can harbour viruses of the SI and, it is presumed, the X4 phenotypes. HIV-2 is much less pathogenic than HIV-1 and is restricted in its worldwide distribution to West Africa . The adoption of "accessory genes" by HIV-2 and its more promiscuous pattern of co-receptor usage (including CD4-independence) may assist
1265-434: A kid who does not want to join in with the activities. HIV The human immunodeficiency viruses ( HIV ) are two species of Lentivirus (a subgroup of retrovirus ) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. Without treatment,
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#17329176313921380-477: A little girl whose mother is awaiting a heart transplant. Neela clashes with Dubenko on two surgical cases and looks to prove her worth as attending material before she leaves County for good. Brenner looks to gain some insight into his abusive childhood. A woman returns to County to claim the baby she had abandoned there. The ER doctors and nurses assist at a camp for children recovering from open heart surgeries where Morris proposes to Claudia and Brenner befriends
1495-466: A major setback after an accident involving Alex Taggart while Neela Rasgotra is forced to make some tough decisions, both personal and professional. To mark the end of the series after 15 years, several former cast members make a return to the show. Mark Greene, Robert Romano, and Kerry Weaver appear in a flashback episode that explores Banfield's history with County General while John Carter returns to work at County although, unbeknown to his colleagues, he
1610-600: A more stable conformation following the NC binding, in which both the DIS and the U5:AUG regions of the gRNA participate in extensive base pairing. RNA can also be processed to produce mature messenger RNAs (mRNAs). In most cases, this processing involves RNA splicing to produce mRNAs that are shorter than the full-length genome. Which part of the RNA is removed during RNA splicing determines which of
1725-457: A new kid!" (Jackie Robbins’s son Jesse was murdered in Season 7 by gang members). Peter later goes to his supervisor, Dr. Robert Romano , and asks for such a schedule, but Romano cannot offer only daytime hours. Peter hands in his resignation, and he goes to the out-of-town clinic where his girlfriend Cleo Finch now works to try to get a job there. He is successful and gets the hours he had promised
1840-447: A number of mechanisms, including pyroptosis of abortively infected T cells, apoptosis of uninfected bystander cells, direct viral killing of infected cells, and killing of infected CD4 T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4 T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections, leading to
1955-460: A strain of SIV found in sooty mangabees. Since HIV-1 is derived from SIVcpz, and HIV-2 from SIVsm, the genetic sequence of HIV-2 is only partially homologous to HIV-1 and more closely resembles that of SIVsm. Many HIV-positive people are unaware that they are infected with the virus. For example, in 2001 less than 1% of the sexually active urban population in Africa had been tested, and this proportion
2070-558: A target T cell via a virological synapse . Secondly, an antigen-presenting cell (APC), such as a macrophage or dendritic cell, can transmit HIV to T cells by a process that either involves productive infection (in the case of macrophages) or capture and transfer of virions in trans (in the case of dendritic cells). Whichever pathway is used, infection by cell-to-cell transfer is reported to be much more efficient than cell-free virus spread. A number of factors contribute to this increased efficiency, including polarised virus budding towards
2185-456: Is an adaptation for repair of genome damage, and that recombinational variation is a byproduct that may provide a separate benefit. The final step of the viral cycle, assembly of new HIV-1 virions, begins at the plasma membrane of the host cell. The Env polyprotein (gp160) goes through the endoplasmic reticulum and is transported to the Golgi apparatus where it is cleaved by furin resulting in
2300-533: Is assigned to Benton, who proceeds to give Carter a hard time. They seldom get along and their personalities clash on many occasions. Benton is more ambitious and focused on surgery whereas Carter is more compassionate and willing to spend time with patients, a trait that "drove [Benton] crazy" as he put it to Cleo, although he considered Carter to be a talented and smart doctor. In Season 3, Benton develops appendicitis and Carter operates on him. However, Carter eventually decided to leave surgery for emergency medicine ,
2415-507: Is bound with the CD4 protein, the envelope complex undergoes a structural change, exposing the chemokine receptor binding domains of gp120 and allowing them to interact with the target chemokine receptor. This allows for a more stable two-pronged attachment, which allows the N-terminal fusion peptide gp41 to penetrate the cell membrane. Repeat sequences in gp41, HR1, and HR2 then interact, causing
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#17329176313922530-661: Is deaf and looks into surgeries to restore his ability to hear, but he later makes his peace with who Reese is, and he and Carla teach him to communicate through sign language . Later, Carla begins a new relationship with a man named Roger McGrath (which she clumsily, and unsuccessfully, tried to keep a secret from a non-plussed Peter) and eventually marries him. At the end of Season 5, Carla more or less tells Peter that her new marriage to Roger means she will be taking Reese with them to Roger's new job in Germany and responds to Peter's shocked and angry response by saying "this WILL happen". At
2645-424: Is even lower in rural populations. Furthermore, in 2001 only 0.5% of pregnant women attending urban health facilities were counselled, tested or received their test results. Again, this proportion is even lower in rural health facilities. Since donors may therefore be unaware of their infection, donor blood and blood products used in medicine and medical research are routinely screened for HIV. HIV-1 testing
2760-424: Is forced to move away from County to work better hours in another hospital, in order to gain custody of Reese. In his last surgery at County, Benton miraculously saves a six-year-old victim of a shooting accident. After leaving the series, Benton was seen a few more times. The first time was when he was passing the torch to Dr. Corday and she told him that her marriage to Benton's friend and colleague Dr. Mark Greene
2875-464: Is high as the glycans shield the underlying viral protein from neutralisation by antibodies. This is one of the most densely glycosylated molecules known and the density is sufficiently high to prevent the normal maturation process of glycans during biogenesis in the endoplasmic and Golgi apparatus. The majority of the glycans are therefore stalled as immature 'high-mannose' glycans not normally present on human glycoproteins that are secreted or present on
2990-471: Is in desperate need of a kidney transplant. Peter Benton, Doug Ross, Carol Hathaway, Susan Lewis, Elizabeth Corday, and Ray Barnett return in various episodes. The series ends with one final multiple casualty incident that brings multiple patients to the ER, and shows that life goes on at County General. The final season included special appearances by departed main and recurring cast members: Gates hurries to
3105-399: Is initially done using an enzyme-linked immunosorbent assay (ELISA) to detect antibodies to HIV-1. Specimens with a non-reactive result from the initial ELISA are considered HIV-negative, unless new exposure to an infected partner or partner of unknown HIV status has occurred. Specimens with a reactive ELISA result are retested in duplicate. If the result of either duplicate test is reactive,
3220-447: Is largely confined to West Africa . HIV is similar in structure to other retroviruses. It is roughly spherical with a diameter of about 120 nm , around 100,000 times smaller in volume than a red blood cell . It is composed of two copies of positive- sense single-stranded RNA that codes for the virus' nine genes enclosed by a conical capsid composed of 2,000 copies of the viral protein p24 . The single-stranded RNA
3335-412: Is likely that both doctors kept in limited contact with each other while working at different hospitals. Dr. Romano eventually offers Benton an attending trauma surgeon position, but when a Medicare patient needs surgery that Romano refuses to allow to be performed, Benton calls social services and informs them of the refusal of care. Romano intercepts the patient as social services arrive and performs
3450-601: Is more likely, leading to immunodeficiency. Three groups of HIV-1 have been identified on the basis of differences in the envelope ( env ) region: M, N, and O. Group M is the most prevalent and is subdivided into eight subtypes (or clades ), based on the whole genome, which are geographically distinct. The most prevalent are subtypes B (found mainly in North America and Europe), A and D (found mainly in Africa), and C (found mainly in Africa and Asia); these subtypes form branches in
3565-555: Is present as both free virus particles and virus within infected immune cells . Research has shown (for both same-sex and opposite-sex couples) that HIV is not contagious during sexual intercourse without a condom if the HIV-positive partner has a consistently undetectable viral load . HIV infects vital cells in the human immune system, such as helper T cells (specifically CD4 T cells), macrophages , and dendritic cells . HIV infection leads to low levels of CD4 T cells through
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3680-414: Is quickly attracted to Benton, though he initially disregards her attentions. At length, Elizabeth tells him she believes that he does not want to pursue a relationship with her because of their racial difference, and Benton finally grudgingly admits to her that "I do have a problem dating white women." Professionally, Benton and Corday attempt to outdo each other several times and both are eventually given
3795-603: Is strongly opposed. One night when Benton is watching his mother in Jackie's home, she falls down the stairs and breaks her hip. Benton meets Jeanie Boulet , a married Physician Assistant , at the hospital. Impressed, he hires her to work with his mother as a physical therapist . Benton's mother dies, devastating him, and when Jeanie comforts him, they end up having an affair. In Season 2, Benton's affair with Jeanie ends. Jeanie separates from her husband Al and learns that he contracted HIV from an affair, and furthermore that he passed
3910-607: Is suspended and comes close to losing his job before Morgenstern finally comes forward with the videotape of the operation, which exonerates his former student. Morgenstern then resigns from the hospital, and a distraught Peter begins an affair with Elizabeth. They remain together through much of the following two years, although their relationship eventually begins to suffer due to Peter's needing to spend more time attending to Reese. Elizabeth helps him realize that their romance isn't going anywhere, and they end their affair, though they remain close friends and colleagues. Their friendship
4025-534: Is the victim of the ambulance explosion. Despite the rallying efforts of his workplace colleagues, he succumbs to his injuries and dies. The season introduces Cate Banfield as new ER chief, a woman with a seemingly mysterious past with County General. Luka Kovač and Abby Lockhart leave for a new life in Boston, Brenner must deal with issues surrounding his childhood, and he comes to a crossroads in his relationship with Neela, Samantha Taggart and Tony Gates' relationship suffers
4140-412: Is tightly bound to nucleocapsid proteins, p7, and enzymes needed for the development of the virion such as reverse transcriptase , proteases , ribonuclease and integrase . A matrix composed of the viral protein p17 surrounds the capsid ensuring the integrity of the virion particle. This is, in turn, surrounded by the viral envelope , that is composed of the lipid bilayer taken from the membrane of
4255-429: Is to Carter. As a going-away present, Carter hands Benton a train token; it is the same one Benton had given him shortly after he started in the ER. Carter was left exhausted and distraught after a shift where the ER had handled a mass casualty, and when he admitted the night had devastated him and Benton simply gave him the token and said that if he was serious about being a good doctor, he would use it to come back to work
4370-504: Is troubled, however, when Elizabeth approaches the hospital staff with the idea of a trauma surgical fellowship . Benton withdraws his tentative commitment to Romano's cardiothoracic fellowship (which would be extremely time-consuming) and campaigns for and is granted the trauma fellowship. Elizabeth feels betrayed by Peter and, wishing to stay at County, takes Romano's cardiothoracic fellowship offer. Alex Kingston , who played Corday, later said: "[Y]ou see interracial relationships all over
4485-534: Is unknown how often such mixed packaging occurs under natural conditions. Bonhoeffer et al. suggested that template switching by reverse transcriptase acts as a repair process to deal with breaks in the single-stranded RNA genome. In addition, Hu and Temin suggested that recombination is an adaptation for repair of damage in the RNA genomes. Strand switching (copy-choice recombination) by reverse transcriptase could generate an undamaged copy of genomic DNA from two damaged single-stranded RNA genome copies. This view of
4600-633: The African green monkey (SIVagm) and sooty mangabey (SIVsmm) are thought to have a long evolutionary history with their hosts. These hosts have adapted to the presence of the virus, which is present at high levels in the host's blood, but evokes only a mild immune response, does not cause the development of simian AIDS, and does not undergo the extensive mutation and recombination typical of HIV infection in humans. In contrast, when these strains infect species that have not adapted to SIV ("heterologous" or similar hosts such as rhesus or cynomologus macaques ),
4715-541: The CCR5-Δ32 mutation are resistant to infection by the R5 virus, as the mutation leaves HIV unable to bind to this co-receptor, reducing its ability to infect target cells. Sexual intercourse is the major mode of HIV transmission. Both X4 and R5 HIV are present in the seminal fluid , which enables the virus to be transmitted from a male to his sexual partner . The virions can then infect numerous cellular targets and disseminate into
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4830-445: The adsorption of glycoproteins on its surface to receptors on the target cell followed by fusion of the viral envelope with the target cell membrane and the release of the HIV capsid into the cell. Entry to the cell begins through interaction of the trimeric envelope complex ( gp160 spike) on the HIV viral envelope and both CD4 and a chemokine co-receptor (generally either CCR5 or CXCR4 , but others are known to interact) on
4945-421: The gag polyproteins still need to be cleaved into the actual matrix, capsid and nucleocapsid proteins. This cleavage is mediated by the packaged viral protease and can be inhibited by antiretroviral drugs of the protease inhibitor class. The various structural components then assemble to produce a mature HIV virion. Only mature virions are then able to infect another cell. The classical process of infection of
5060-514: The microtubule -based transport to the nucleus, the viral single-strand RNA genome is transcribed into double-strand DNA, which is then integrated into a host chromosome. HIV can infect dendritic cells (DCs) by this CD4-CCR5 route, but another route using mannose-specific C-type lectin receptors such as DC-SIGN can also be used. DCs are one of the first cells encountered by the virus during sexual transmission. They are currently thought to play an important role by transmitting HIV to T cells when
5175-403: The phylogenetic tree representing the lineage of the M group of HIV-1. Co-infection with distinct subtypes gives rise to circulating recombinant forms (CRFs). In 2000, the last year in which an analysis of global subtype prevalence was made, 47.2% of infections worldwide were of subtype C, 26.7% were of subtype A/CRF02_AG, 12.3% were of subtype B, 5.3% were of subtype D, 3.2% were of CRF_AE, and
5290-438: The α -chemokine receptor, CXCR4 , for entry. Dual-tropic HIV-1 strains are thought to be transitional strains of HIV-1 and thus are able to use both CCR5 and CXCR4 as co-receptors for viral entry. The α -chemokine SDF-1 , a ligand for CXCR4, suppresses replication of T-tropic HIV-1 isolates. It does this by down-regulating the expression of CXCR4 on the surface of HIV target cells. M-tropic HIV-1 isolates that use only
5405-427: The β -chemokine receptor, CCR5 , for entry and are thus able to replicate in both macrophages and CD4 T cells. This CCR5 co-receptor is used by almost all primary HIV-1 isolates regardless of viral genetic subtype. Indeed, macrophages play a key role in several critical aspects of HIV infection. They appear to be the first cells infected by HIV and perhaps the source of HIV production when CD4 cells become depleted in
5520-458: The "21 Most Annoying TV Characters Ever". ER (season 15) The fifteenth and final season of the American fictional drama television series ER premiered on September 25, 2008, and concluded on April 2, 2009, in a two-hour episode preceded by a one-hour retrospective special. It consists of 22 episodes. Because actors Mekhi Phifer , Goran Visnjic , and Maura Tierney had been told
5635-420: The 14th season would be the last one, they had no plans or interest in returning for S15. The producers agreed to film two S15 episodes at the very end of the Season 14 production cycle so that all three actors could finish their time on the show and move on to other projects. Tierney would make a one-scene guest appearance in an episode near the end of Season 15. The final season opens up revealing Gregory Pratt
5750-423: The 15th and final season of ER , at the end of the episode "The Book of Abby", long-serving nurse Haleh Adams shows the departing Abby Lockhart a closet wall where all the past doctors and employees have put their locker name tags. Among them, the tag "Benton" can be seen. Benton returns in the 19th episode of the 15th (final) season of ER in the episode "Old Times" which first was broadcast on 12 March 2009. In
5865-583: The CCR5 receptor are termed R5; those that use only CXCR4 are termed X4, and those that use both, X4R5. However, the use of co-receptors alone does not explain viral tropism, as not all R5 viruses are able to use CCR5 on macrophages for a productive infection and HIV can also infect a subtype of myeloid dendritic cells , which probably constitute a reservoir that maintains infection when CD4 T cell numbers have declined to extremely low levels. Some people are resistant to certain strains of HIV. For example, people with
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#17329176313925980-405: The DIS (dimerization initiation signal) hairpin is exposed. The formation of the gRNA dimer is mediated by a 'kissing' interaction between the DIS hairpin loops of the gRNA monomers. At the same time, certain guanosine residues in the gRNA are made available for binding of the nucleocapsid (NC) protein leading to the subsequent virion assembly. The labile gRNA dimer has been also reported to achieve
6095-433: The ER. In the 2nd episode of Season 8, Carla is killed in a car accident. Peter takes Reese into his full custody, but when Roger continues to appeal for time with his stepson, Peter insists that Roger move on with his life and stay away. Roger sues Peter for custody of Reese, and his lawyers force Peter to address the fact that he may not be Reese's biological father. Peter takes another paternity test and this time learns
6210-540: The Germany-based promotion over the time he spent in court and they will have to remain in Chicago; Peter bluntly says he is sorry about the job but not sorry that his son will remain in the same city as him. In Season 7, Carla shows up anew to openly flirt with Peter, cause problems between him and his new girlfriend Cleo Finch, and lie to Roger about Peter hitting on her to the point where Roger and Peter have an altercation in
6325-419: The HIV env gene, allows the virus to attach to target cells and fuse the viral envelope with the target cell's membrane releasing the viral contents into the cell and initiating the infectious cycle. As the sole viral protein on the surface of the virus, the envelope protein is a major target for HIV vaccine efforts. Over half of the mass of the trimeric envelope spike is N-linked glycans . The density
6440-441: The HIV protein-coding sequences is translated. Mature HIV mRNAs are exported from the nucleus into the cytoplasm , where they are translated to produce HIV proteins, including Rev . As the newly produced Rev protein is produced it moves to the nucleus, where it binds to full-length, unspliced copies of virus RNAs and allows them to leave the nucleus. Some of these full-length RNAs function as mRNAs that are translated to produce
6555-570: The HIV virological synapse in vivo . The many dissemination mechanisms available to HIV contribute to the virus' ongoing replication in spite of anti-retroviral therapies. HIV differs from many viruses in that it has very high genetic variability . This diversity is a result of its fast replication cycle , with the generation of about 10 virions every day, coupled with a high mutation rate of approximately 3 x 10 per nucleotide base per cycle of replication and recombinogenic properties of reverse transcriptase. This complex scenario leads to
6670-516: The LTR promoter acting by binding the TAR RNA element. The TAR may also be processed into microRNAs that regulate the apoptosis genes ERCC1 and IER3 . The rev protein (p19) is involved in shuttling RNAs from the nucleus and the cytoplasm by binding to the RRE RNA element. The vif protein (p23) prevents the action of APOBEC3G (a cellular protein that deaminates cytidine to uridine in
6785-433: The U.S.: Although IFA can be used to confirm infection in these ambiguous cases, this assay is not widely used. In general, a second specimen should be collected more than a month later and retested for persons with indeterminate western blot results. Although much less commonly available, nucleic acid testing (e.g., viral RNA or proviral DNA amplification method) can also help diagnosis in certain situations. In addition,
6900-409: The adaptive benefit of recombination in HIV could explain why each HIV particle contains two complete genomes, rather than one. Furthermore, the view that recombination is a repair process implies that the benefit of repair can occur at each replication cycle, and that this benefit can be realized whether or not the two genomes differ genetically. On the view that recombination in HIV is a repair process,
7015-423: The advent of AIDS. HIV-positive patients acquire an enormously broad spectrum of opportunistic infections, which was particularly problematic prior to the onset of HAART therapies; however, the same infections are reported among HIV-infected patients examined post-mortem following the onset of antiretroviral therapies. Thus, during the course of infection, viral adaptation to the use of CXCR4 instead of CCR5 may be
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#17329176313927130-403: The animals develop AIDS and the virus generates genetic diversity similar to what is seen in human HIV infection. Chimpanzee SIV (SIVcpz), the closest genetic relative of HIV-1, is associated with increased mortality and AIDS-like symptoms in its natural host. SIVcpz appears to have been transmitted relatively recently to chimpanzee and human populations, so their hosts have not yet adapted to
7245-542: The average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype . In most cases, HIV is a sexually transmitted infection and occurs by contact with or transfer of blood , pre-ejaculate , semen , and vaginal fluids . Non-sexual transmission can occur from an infected mother to her infant during pregnancy , during childbirth by exposure to her blood or vaginal fluid, and through breast milk . Within these bodily fluids, HIV
7360-592: The cell as new virus particles that will begin the replication cycle anew. Two types of HIV have been characterized: HIV-1 and HIV-2. HIV-1 is the virus that was initially discovered and termed both lymphadenopathy associated virus (LAV) and human T-lymphotropic virus 3 (HTLV-III). HIV-1 is more virulent and more infective than HIV-2, and is the cause of the majority of HIV infections globally. The lower infectivity of HIV-2, compared to HIV-1, implies that fewer of those exposed to HIV-2 will be infected per exposure. Due to its relatively poor capacity for transmission, HIV-2
7475-470: The cell types a virus infects. HIV can infect a variety of immune cells such as CD4 T cells , macrophages , and microglial cells . HIV-1 entry to macrophages and CD4 T cells is mediated through interaction of the virion envelope glycoproteins (gp120) with the CD4 molecule on the target cells' membrane and also with chemokine co-receptors . Macrophage-tropic (M-tropic) strains of HIV-1, or non- syncytia -inducing strains (NSI; now called R5 viruses ) use
7590-652: The characters competed with each other professionally and failed to be adequately supportive of each other in their personal crises, so Corday ends the relationship in Season 5. According to an article published in Jet in 1999, Eriq La Salle was the reason why the romance dissolved. He was unhappy that Benton's interracial romance with Corday was being shown as less problematic than his prior romances with black characters, such as Jeanie Boulet (played by Gloria Reuben ) and Carla Reese (played by Lisa Nicole Carson ). In an interview, La Salle stated, "As an African-American man, it becomes
7705-454: The collapse of the extracellular portion of gp41 into a hairpin shape. This loop structure brings the virus and cell membranes close together, allowing fusion of the membranes and subsequent entry of the viral capsid. After HIV has bound to the target cell, the HIV RNA and various enzymes, including reverse transcriptase, integrase, ribonuclease, and protease, are injected into the cell. During
7820-447: The development of AIDS. HIV is a member of the genus Lentivirus , part of the family Retroviridae . Lentiviruses have many morphologies and biological properties in common. Many species are infected by lentiviruses, which are characteristically responsible for long-duration illnesses with a long incubation period . Lentiviruses are transmitted as single-stranded , positive- sense , enveloped RNA viruses . Upon entry into
7935-577: The development of stable recombinant forms of the viral spike by the introduction of an intersubunit disulphide bond and an isoleucine to proline mutation ( radical replacement of an amino acid) in gp41. The so-called SOSIP trimers not only reproduce the antigenic properties of the native viral spike, but also display the same degree of immature glycans as presented on the native virus. Recombinant trimeric viral spikes are promising vaccine candidates as they display less non-neutralising epitopes than recombinant monomeric gp120, which act to suppress
8050-423: The disease on to her; however, Jeanie does not pass the virus to Peter. In Season 3, Peter becomes involved with a former girlfriend, Carla Reese, who soon becomes pregnant. She gives birth to a son, Reese Benton, who is born prematurely. It is later discovered that, possibly from complications from Reese's prematurity or his NICU treatment, the boy is deaf. Peter, at first, has difficulty accepting that his son
8165-488: The episode, he visits an old friend and former student John Carter who is awaiting a kidney transplant, and it is revealed that Benton has left private practice for a surgical attending position at Northwestern University Hospital now that Reese is thirteen. He is seen wearing a wedding ring, so it is assumed he has married Cleo Finch who Benton states is at home watching Reese. Benton decides to observe Carter's transplant and Benton's insistence on being thorough, which annoys
8280-431: The generation of many variants of HIV in a single infected patient in the course of one day. This variability is compounded when a single cell is simultaneously infected by two or more different strains of HIV. When simultaneous infection occurs, the genome of progeny virions may be composed of RNA strands from two different strains. This hybrid virion then infects a new cell where it undergoes replication. As this happens,
8395-576: The generation of recombinational variation would be a consequence, but not the cause of, the evolution of template switching. HIV-1 infection causes chronic inflammation and production of reactive oxygen species . Thus, the HIV genome may be vulnerable to oxidative damage , including breaks in the single-stranded RNA. For HIV, as well as for viruses in general, successful infection depends on overcoming host defense strategies that often include production of genome-damaging reactive oxygen species. Thus, Michod et al. suggested that recombination by viruses
8510-552: The genetic information that is transmitted from parental to progeny genomes. Viral recombination produces genetic variation that likely contributes to the evolution of resistance to anti-retroviral therapy . Recombination may also contribute, in principle, to overcoming the immune defenses of the host. Yet, for the adaptive advantages of genetic variation to be realized, the two viral genomes packaged in individual infecting virus particles need to have arisen from separate progenitor parental viruses of differing genetic constitution. It
8625-431: The ghosts of her past when a critically ill child arrives in the ER. A past encounter with Mark Greene helps her diagnose and confront her own problems. Neela's intern loses his first patient, and struggles to cope. Dr. Morgenstern visits County General upon learning a former mentor is seriously ill. Meanwhile, Sam's sister ( Shannon Woodward ) drops by unexpectedly; Gates and Morris treat an elderly man ( Rance Howard ) who
8740-415: The immune response to target epitopes. The RNA genome consists of at least seven structural landmarks ( LTR , TAR , RRE , PE, SLIP, CRS, and INS), and nine genes ( gag , pol , and env , tat , rev , nef , vif , vpr , vpu , and sometimes a tenth tev , which is a fusion of tat , env and rev ), encoding 19 proteins. Three of these genes, gag , pol , and env , contain information needed to make
8855-518: The integrated DNA provirus is transcribed into RNA. The full-length genomic RNAs (gRNA) can be packaged into new viral particles in a pseudodiploid form. The selectivity in the packaging is explained by the structural properties of the dimeric conformer of the gRNA. The gRNA dimer is characterized by a tandem three-way junction within the gRNA monomer, in which the SD and AUG hairpins , responsible for splicing and translation respectively, are sequestered and
8970-539: The judge, and he is awarded sole custody of Reese with Roger receiving visitation rights. When a saddened Roger brings Reese's Christmas presents to the hospital later that day, Peter, knowing that Roger is important to Reese, tells Roger to come to his and Cleo's home on Christmas Day and give the presents to Reese himself. He does tell Roger he is doing this not for Roger's sake but for Reese and both men tacitly acknowledge Peter has won. When British surgeon Dr. Elizabeth Corday starts work at County General Hospital, she
9085-530: The medical community, making it impossible for Benton to find a job in Chicago . Corday finds a new job for him in Philadelphia , but Carla will not continue joint custody of Reese if Peter leaves town (citing Peter's resistance to her and her husband Roger's plans to move the year before). Peter is then forced to go to Romano and accept the per diem position. After the court battle between Roger and himself, Benton
9200-500: The message that we're sending as African-Americans or any other group of minorities, that we have the exact same type of exchanges with our mates that we get to see our White counterparts have." In a subsequent episode, Benton was shown to be compassionate to his former girlfriend, Jeanie. Benton was first introduced in the pilot as a second-year surgical resident . When all the attending surgeons are occupied in other surgeries, Benton decides to operate without supervision to control
9315-412: The next day. Carter did return for his scheduled shift but kept that token as a reminder of what the job entailed. In Season 15, he reunited with Carter when he was in need of a kidney transplant. Benton supervises the operation at the hospital where he works and makes sure that his old friend and colleague get the best medical support. As Benton knew that Carter has gone to Africa for the past 4 years, it
9430-479: The opportunity to work with Dr. Robert Romano . Later in the year, Benton assists with a surgery performed by his mentor Dr. David Morgenstern. Morgenstern (who has been somewhat hesitant about surgery following his heart attack ) makes a serious mistake that endangers the patient's life. Benton shoves him out of the way to take over the operation, with Elizabeth walking in too late to see Morgenstern's mistake but witnessing Benton's actions toward Morgenstern. Benton
9545-410: The patient. Macrophages and microglial cells are the cells infected by HIV in the central nervous system . In the tonsils and adenoids of HIV-infected patients, macrophages fuse into multinucleated giant cells that produce huge amounts of virus. T-tropic strains of HIV-1, or syncytia -inducing strains (SI; now called X4 viruses ) replicate in primary CD4 T cells as well as in macrophages and use
9660-438: The pieces after Pratt's death. A new batch of interns as well as the new head of the ER arrive for their first day at County. While adjusting, a bio-terrorist with a bag full of Ricin is admitted with a broken leg. Abby gets a job in Boston and tries to leave County General quietly, but the staff makes it known how much they will miss her. Abby says goodbye and leaves for Boston with Kovač and her son. Banfield must deal with
9775-460: The place [outside America]. I kind of naively thought it would be even more liberal in America. And it couldn't have been further from the truth. In fact, I'm trying to think if there's a television show right now [in 2013] where there's an African American and Caucasian relationship. They're few and far between." In Season 6, Benton began dating Dr. Cleo Finch , an ER pediatrician . Their relationship
9890-406: The remaining 5.3% were composed of other subtypes and CRFs. Most HIV-1 research is focused on subtype B; few laboratories focus on the other subtypes. The existence of a fourth group, "P", has been hypothesised based on a virus isolated in 2009. The strain is apparently derived from gorilla SIV (SIVgor), first isolated from western lowland gorillas in 2006. HIV-2's closest relative is SIVsm,
10005-425: The reverse transcriptase, by jumping back and forth between the two different RNA templates, will generate a newly synthesized retroviral DNA sequence that is a recombinant between the two parental genomes. This recombination is most obvious when it occurs between subtypes. The closely related simian immunodeficiency virus (SIV) has evolved into many strains, classified by the natural host species. SIV strains of
10120-564: The role. I was ready and completely focused. I came into the office with a stethoscope and surgical greens I had left over from [a previous role in] The Human Factor . When I left, I wanted them to say 'That's Dr. Benton'". Within three days of his audition, La Salle was offered the role of Dr. Benton. The name of the character was inspired by The Peter Bent Brigham Hospital (now part of the Brigham and Women's Hospital in Boston , Massachusetts ) which
10235-435: The scene of the ambulance explosion after learning it was Pratt, not Sam, in the ambulance. Pratt is rushed back to County suffering from blast injuries, where the ER staff work to stabilize him. Eventually, a carotid tear develops, and despite the rallying efforts of his colleagues, he dies. Meanwhile, Abby misdiagnoses a patient, and talks about her plans to leave Chicago to start a new life with Kovač, while Morris must pick up
10350-516: The single-stranded viral DNA and/or interferes with reverse transcription ). The vpr protein (p14) arrests cell division at G2/M . The nef protein (p27) down-regulates CD4 (the major viral receptor), as well as the MHC class I and class II molecules. Nef also interacts with SH3 domains . The vpu protein (p16) influences the release of new virus particles from infected cells. The ends of each strand of HIV RNA contain an RNA sequence called
10465-412: The site of cell-to-cell contact, close apposition of cells, which minimizes fluid-phase diffusion of virions, and clustering of HIV entry receptors on the target cell towards the contact zone. Cell-to-cell spread is thought to be particularly important in lymphoid tissues , where CD4 T cells are densely packed and likely to interact frequently. Intravital imaging studies have supported the concept of
10580-673: The specimen is reported as repeatedly reactive and undergoes confirmatory testing with a more specific supplemental test (e.g., a polymerase chain reaction (PCR), western blot or, less commonly, an immunofluorescence assay (IFA)). Only specimens that are repeatedly reactive by ELISA and positive by IFA or PCR or reactive by western blot are considered HIV-positive and indicative of HIV infection. Specimens that are repeatedly ELISA-reactive occasionally provide an indeterminate western blot result, which may be either an incomplete antibody response to HIV in an infected person or nonspecific reactions in an uninfected person. HIV deaths in 2014 excluding
10695-420: The start of Season 6, legal proceedings have begun over Peter's refusal to agree to Carla's demands. Carla once again angers Peter by whining that he should just step aside and agree with her and then shocks Peter by telling him that he may not be Reese's father, saying that she needed him to be a father at the time but Roger can fill that role in the future (back in Season 3, Carla was angry when Peter asked if she
10810-553: The structural proteins Gag and Env. Gag proteins bind to copies of the virus RNA genome to package them into new virus particles. HIV-1 and HIV-2 appear to package their RNA differently. HIV-1 will bind to any appropriate RNA. HIV-2 will preferentially bind to the mRNA that was used to create the Gag protein itself. Two RNA genomes are encapsidated in each HIV-1 particle (see Structure and genome of HIV ). Upon infection and replication catalyzed by reverse transcriptase, recombination between
10925-496: The structural proteins for new virus particles. For example, env codes for a protein called gp160 that is cut in two by a cellular protease to form gp120 and gp41. The six remaining genes, tat , rev , nef , vif , vpr , and vpu (or vpx in the case of HIV-2), are regulatory genes for proteins that control the ability of HIV to infect cells, produce new copies of virus (replicate), or cause disease. The two tat proteins (p16 and p14) are transcriptional transactivators for
11040-423: The surgeon, allows a complication to be resolved and the surgery to be a success. In the series finale , Benton goes to Carter's opening of his new hospital with Reese. He also goes to the afterparty with Carter, Susan Lewis, and Kerry Weaver and meets Elizabeth Corday and Rachel Greene. Dr. Peter Benton was named the #10 Top TV Dad by SocialTechPop in 2011. Entertainment Weekly included him in their list of
11155-474: The surgery, but he is enraged at Peter for calling them. Romano then retracts the idea of an attending trauma surgeon, explaining to Peter that the fines social services and Medicare inflicted on the hospital roughly equal what Peter's yearly salary would have been. Romano then offers Benton a per diem surgical position with reduced benefits and more difficult scheduling, but Benton refuses. Romano also uses his considerable influence to blacklist Benton throughout
11270-427: The target cell surface. Gp120 binds to integrin α 4 β 7 activating LFA-1 , the central integrin involved in the establishment of virological synapses , which facilitate efficient cell-to-cell spreading of HIV-1. The gp160 spike contains binding domains for both CD4 and chemokine receptors. The first step in fusion involves the high-affinity attachment of the CD4 binding domains of gp120 to CD4. Once gp120
11385-413: The target cell, the viral RNA genome is converted (reverse transcribed) into double-stranded DNA by a virally encoded enzyme, reverse transcriptase , that is transported along with the viral genome in the virus particle. The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded enzyme, integrase , and host co-factors . Once integrated,
11500-491: The truth—he is not Reese's biological father. Roger's lawyer makes an issue of the long hours' Peter's job demands, whereas Roger works from home and commands his own schedule. During court, Peter perjures himself on the witness stand and proclaims that he has been given a new schedule with reduced working hours at County General Hospital. A furious Roger confronts Peter about lying, but quickly turns abusive when he dares Peter to hit him and then says Peter "can't give your sister
11615-414: The two HIV envelope glycoproteins, gp41 and gp120 . These are transported to the plasma membrane of the host cell where gp41 anchors gp120 to the membrane of the infected cell. The Gag (p55) and Gag-Pol (p160) polyproteins also associate with the inner surface of the plasma membrane along with the HIV genomic RNA as the forming virion begins to bud from the host cell. The budded virion is still immature as
11730-484: The two genomes can occur. Recombination occurs as the single-strand, positive-sense RNA genomes are reverse transcribed to form DNA. During reverse transcription, the nascent DNA can switch multiple times between the two copies of the viral RNA. This form of recombination is known as copy-choice. Recombination events may occur throughout the genome. Anywhere from two to 20 recombination events per genome may occur at each replication cycle, and these events can rapidly shuffle
11845-570: The viral DNA into the host cell's genome is carried out by another viral enzyme called integrase . The integrated viral DNA may then lie dormant, in the latent stage of HIV infection. To actively produce the virus, certain cellular transcription factors need to be present, the most important of which is NF- κ B (nuclear factor kappa B), which is upregulated when T cells become activated. This means that those cells most likely to be targeted, entered and subsequently killed by HIV are those actively fighting infection. During viral replication,
11960-536: The virus in its adaptation to avoid innate restriction factors present in host cells. Adaptation to use normal cellular machinery to enable transmission and productive infection has also aided the establishment of HIV-2 replication in humans. A survival strategy for any infectious agent is not to kill its host, but ultimately become a commensal organism. Having achieved a low pathogenicity, over time, variants that are more successful at transmission will be selected. The HIV virion enters macrophages and CD4 T cells by
12075-425: The virus is captured in the mucosa by DCs. The presence of FEZ-1 , which occurs naturally in neurons , is believed to prevent the infection of cells by HIV. HIV-1 entry, as well as entry of many other retroviruses, has long been believed to occur exclusively at the plasma membrane. More recently, however, productive infection by pH -independent, clathrin-mediated endocytosis of HIV-1 has also been reported and
12190-463: The virus may become latent , allowing the virus and its host cell to avoid detection by the immune system, for an indeterminate amount of time. The virus can remain dormant in the human body for up to ten years after primary infection; during this period the virus does not cause symptoms. Alternatively, the integrated viral DNA may be transcribed , producing new RNA genomes and viral proteins, using host cell resources, that are packaged and released from
12305-403: The virus to evade the body's immune system. The reverse transcriptase also has ribonuclease activity that degrades the viral RNA during the synthesis of cDNA, as well as DNA-dependent DNA polymerase activity that creates a sense DNA from the antisense cDNA. Together, the cDNA and its complement form a double-stranded viral DNA that is then transported into the cell nucleus . The integration of
12420-537: The virus. This virus has also lost a function of the nef gene that is present in most SIVs. For non-pathogenic SIV variants, nef suppresses T cell activation through the CD3 marker. Nef 's function in non-pathogenic forms of SIV is to downregulate expression of inflammatory cytokines , MHC-1 , and signals that affect T cell trafficking. In HIV-1 and SIVcpz, nef does not inhibit T-cell activation and it has lost this function. Without this function, T cell depletion
12535-475: The whole organism. However, a selection process leads to a predominant transmission of the R5 virus through this pathway. In patients infected with subtype B HIV-1, there is often a co-receptor switch in late-stage disease and T-tropic variants that can infect a variety of T cells through CXCR4. These variants then replicate more aggressively with heightened virulence that causes rapid T cell depletion, immune system collapse, and opportunistic infections that mark
12650-400: Was a teaching hospital for Harvard Medical School , where series originator Michael Crichton studied medicine, although (perhaps coincidentally) the birth name of Crichton's wife at the time, Anne-Marie Martin , was also Benton. Several relationships were scripted into the character's narrative. In Season 4 he began dating Dr. Elizabeth Corday , played by Alex Kingston . Both surgeons and
12765-448: Was assaulted on the street; and Brenner is shocked by a patient's diagnosis. As Carter awaits his kidney transplant, he gets a surprise visit from Benton. Meanwhile, Ross and Hathaway must receive consent for organ donation from a woman who is grief-stricken over the sudden death of her grandson, but Sam and Neela are stuck at the airport with the transplant organs in hand. Banfield bonds with an abandoned baby. Brenner continues to care for
12880-425: Was in trouble. His next appearance was at the funeral of Greene. Benton appears in a photo as part of a slideshow at Dr. Carter's farewell party, and Benton is heard in a voiceover memory as Carter leaves the ER for the last time in the 11th-season finale. Eriq La Salle made an uncredited appearance in the opening of "Heal Thyself" to tell the audience of the death of the show's creator Michael Crichton . During
12995-448: Was recently suggested to constitute the only route of productive entry. Shortly after the viral capsid enters the cell, an enzyme called reverse transcriptase liberates the positive-sense single-stranded RNA genome from the attached viral proteins and copies it into a complementary DNA (cDNA) molecule. The process of reverse transcription is extremely error-prone, and the resulting mutations may cause drug resistance or allow
13110-435: Was stormy because of Peter's ex-girlfriend Carla, but in Season 8 they leave Chicago along with Benton's son Reese to start a new life. Peter Benton and Cleo Finch transferred to a different hospital. In the season 15 episode "Old Times," Benton is seen wearing a wedding ring, and it is assumed he and Cleo are now married. In the pilot episode, John Carter is introduced as a third-year medical student on his ER rotation. He
13225-474: Was sure he was the father). Peter takes a DNA test to determine whether or not Carla's suspicions are true, but he chooses not to receive the results and decides he will be Reese's father regardless of biology. Carla does not respond to Peter's pleas to end the legal fight, but on Christmas Eve shows up angrily at the hospital with Reese and bitterly tells him "you win" and sarcastically thanks him for ruining her and Roger's lives, as Roger's boss booted him from
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