Case Report: HIV Elite Controller, 15-Year Follow-Up
DOI:
https://doi.org/10.17533/udea.iatreia.235Keywords:
AIDS, Elite Controllers, HIV, Viral LoadAbstract
A small cohort of HIV patients, not receiving antiretroviral therapy, exhibits low levels of viremia, normal or slightly elevated CD4+ cell counts, normal immune activity levels, and slow progression towards AIDS. Given the absence of published studies in Colombia on this subject, we present the case of a 69-year-old elite controller treated at a health institution in Pasto, Colombia, diagnosed with HIV since 1998 and with undetectable viral loads. The patient also had hepatitis C in 2019 and latent tuberculosis in 2017. Currently, the virus remains undetectable without immunological compromise. The prevalence of elite controllers is low, and they are considered cases of interest since they may offer options for disease prevention and cure.
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(1) Killian MS, Vyas GN, Mehta R, Young K, Ebrahim O. Possible transmission of human immunodeficiency virus-1 infection from an elite controller to a patient who progressed to acquired immunodeficiency syndrome: A case report. J Med Case Rep [Internet]. 2012;6(1):291. https://dx.doi.org/10.1186/1752-1947-6-291
(2) Borrell M, Fernández I, Etcheverrry F, Ugarte A, Plana M, Leal L, et al. High rates of long-term progression in HIV-1-positive elite controllers. J Int AIDS Soc [Internet]. 2021;24(2):e25675. https://doi.org/10.1002/jia2.25675
(3) Sivay MV, Fogel JM, Wang J, Zhang Y, Piwowar-Manning E, Clarke W, et al. Natural control of HIV infection in young women in South Africa: HPTN 068. HIV Clin Trials [Internet]. 2018;19(5):202-8. https://doi.org/10.1080/15284336.2018.1531534
(4) W. Lenis. Enfermedad por VIH, Inhibidores de integrasa y el futuro de los controladores elite, revisión bibliográfica. Infectio [Internet]. 2019;23(S1):61-72. http://dx.doi.org/10.22354/in.v23i1.761
(5) Lunardi LW, Bragatte MAS, Vieira GF. The influence of HLA/HIV genetics on the occurrence of elite controllers and a need for therapeutics geotargeting view. Brazilian J Infect Dis [Internet]. 2021;25(5). https://doi.org/10.1016/j.bjid.2021.101619
(6) Taborda NA, Rugeles MT, Montoya CJ. Spontaneous control of HIV replication, but not HAART-induced viral suppression, is associated with lower activation of immune cells. J Acquir Immune Defic Syndr [Internet]. 2014;66(4):365-9. https://doi.org/10.1097/QAI.0000000000000162
(7) Olson AD, Meyer L, Prins M, Thiebaut R, Gurdasani D, Guiguet M, et al. An evaluation of HIV elite controller definitions within a large seroconverter cohort collaboration. PLoS One [Internet]. 2014;9(1):e86719. https://doi.org/10.1371/journal.pone.0086719
(8) Mendoza D, Johnson SA, Peterson BA, Natarajan V, Salgado M, Dewar RL, et al. Comprehensive analysis of unique cases with extraordinary control over HIV replication. Blood [Internet]. 2012;119(20):4645-55. https://doi.org/10.1182/blood-2011-10-381996
(9) Crowell TA, Gebo KA, Blankson JN, Korthuis PT, Yehia BR, Rutstein RM, et al. Hospitalization Rates and Reasons Among HIV Elite Controllers and Persons With Medically Controlled HIV Infection. J Infect Dis [Internet]. 2015;211(11):1692-1702. https://doi.org/10.1093/infdis/jiu809
(10) Phetsouphanh C, Aldridge D, Marchi E, Munier CML, Meyerowitz J, Murray L, et al. Maintenance of Functional CD57+ Cytolytic CD4+ T Cells in HIV+ Elite Controllers. Front Immunol [Internet]. 2019;10:1844. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694780/
(11) Lopez-Galindez C, Pernas M, Casado C, Olivares I, Lorenzo-Redondo R. Elite controllers and lessons learned for HIV-1 cure. Curr Opin Virol [Internet]. 2019;38:31-6. https://doi.org/10.1016/j.coviro.2019.05.010
(12) Tarancon-Diez L, Rodríguez-Gallego E, Rull A, Peraire J, Viladés C, Portilla I, et al. Immunometabolism is a key factor for the persistent spontaneous elite control of HIV-1 infection. EBioMedicine [Internet]. 2019;42:86-96. https://doi.org/10.1016/j.ebiom.2019.03.004
(13) Spivak AM, Salgado M, Rabi SA, O’Connell KA, Blankson JN. Circulating monocytes are not a major reservoir of HIV-1 in elite suppressors. J Virol [Internet]. 2011;85(19):10399-403. https://doi.org/10.1128/JVI.05409-11
(14) Lu W, Chen S, Lai C, Lai M, Fang H, Dao H, et al. Suppression of HIV Replication by CD8(+) Regulatory T-Cells in Elite Controllers. Front Immunol [Internet]. 2016;7:134. https://doi.org/10.3389/fimmu.2016.00134
(15) Caetano DG, Paula HHS, Bello G, Hoagland B, Villela LM, Grinsztejn B, et al. HIV-1 elite controllers present a high frequency of activated regulatory T and Th17 cells. PLoS One [Internet]. 2020;15(2):e0228745. https://doi.org/10.1371/journal.pone.0228745
(16) Claireaux M, Robinot R, Kervevan J, Patgaonkar M, Staropoli I, et al Low CCR5 expression protects HIV-specific CD4+ T cells of elite controllers from viral entry. Nat Común [Internet]. 2022 [citado el 9 de septiembre de 2023];13(1). DOI: 10.1038/s41467-022-28130-0
(17) Hartana CA, Yu XG. Immunological effector mechanisms in HIV-1 elite controllers. Curr Opin HIV AIDS [Internet]. 2021;16(5):243-8. https://doi.org/10.1097/coh.0000000000000693
(18) Stafford KA, Rikhtegaran-Tehrani Z, Saadat S, Ebadi M, Redfield RR, Sajadi MM. Long-term follow-up of elite controllers: Higher risk of complications with HCV coinfection, no association with HIV disease progression. Medicine (Baltimore) [Internet]. 2017;96(26):e7348-e7348. https://doi.org/10.1097/MD.0000000000007348
(19) Yang OO, Cumberland WG, Escobar R, Liao D, Chew KW. Demographics and natural history of HIV-1-infected spontaneous controllers of viremia. AIDS [Internet]. 2017;31(8):1091-8. https://doi.org/10.1097/QAD.0000000000001443
(20) Okulicz JF, Lambotte O. Epidemiology and clinical characteristics of elite controllers. Curr Opin HIV AIDS [Internet]. 2011;6(3):163-8. https://doi.org/10.1097/COH.0b013e328344f35e
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