TY - JOUR
T1 - Epidemiology and clinical characteristics of elite controllers
AU - Okulicz, Jason F.
AU - Lambotte, Olivier
PY - 2011/5
Y1 - 2011/5
N2 - Purpose of review: Recent studies have been published characterizing the epidemiology of elite controllers. The demographic features, clinical characteristics, and HIV disease outcomes of elite controllers are summarized. Recent findings: Elite controllers are defined by the ability to spontaneously suppress plasma viremia. Despite differing definitions in the literature, studies have shown that elite control of HIV infection is established soon after seroconversion and occurs in less than 1% of HIV-infected individuals. Elite controllers are demographically heterogeneous with diverse racial backgrounds and modes of HIV transmission, though genetic studies demonstrate an overrepresentation of protective HLA alleles. Elite controllers typically have elevated CD4 cell counts, stable CD4 trajectories, and more favorable clinical outcomes compared with viremic patients. A proportion of elite controllers, however, may experience HIV disease progression with loss of virologic control, CD4 cell declines, and rarely AIDS-defining events. Summary: Elite controllers are a subgroup of HIV-infected individuals characterized by the ability to spontaneously maintain virologic control. The mechanisms underlying elite control are aggressively being sought to guide vaccine development and novel therapeutic strategies. As elite control may be a temporary state, the ability to distinguish and further characterize elite controllers with long-term clinical success from those with HIV disease progression is of major importance.
AB - Purpose of review: Recent studies have been published characterizing the epidemiology of elite controllers. The demographic features, clinical characteristics, and HIV disease outcomes of elite controllers are summarized. Recent findings: Elite controllers are defined by the ability to spontaneously suppress plasma viremia. Despite differing definitions in the literature, studies have shown that elite control of HIV infection is established soon after seroconversion and occurs in less than 1% of HIV-infected individuals. Elite controllers are demographically heterogeneous with diverse racial backgrounds and modes of HIV transmission, though genetic studies demonstrate an overrepresentation of protective HLA alleles. Elite controllers typically have elevated CD4 cell counts, stable CD4 trajectories, and more favorable clinical outcomes compared with viremic patients. A proportion of elite controllers, however, may experience HIV disease progression with loss of virologic control, CD4 cell declines, and rarely AIDS-defining events. Summary: Elite controllers are a subgroup of HIV-infected individuals characterized by the ability to spontaneously maintain virologic control. The mechanisms underlying elite control are aggressively being sought to guide vaccine development and novel therapeutic strategies. As elite control may be a temporary state, the ability to distinguish and further characterize elite controllers with long-term clinical success from those with HIV disease progression is of major importance.
KW - HIV
KW - HLA B57
KW - elite controllers
KW - vaccine
KW - viral load
UR - http://www.scopus.com/inward/record.url?scp=79955467398&partnerID=8YFLogxK
U2 - 10.1097/COH.0b013e328344f35e
DO - 10.1097/COH.0b013e328344f35e
M3 - Article
C2 - 21502920
AN - SCOPUS:79955467398
SN - 1746-630X
VL - 6
SP - 163
EP - 168
JO - Current Opinion in HIV and AIDS
JF - Current Opinion in HIV and AIDS
IS - 3
ER -