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Review
. 2020 Dec;11(1):889-897.
doi: 10.1080/21505594.2020.1788887.

Elite controllers: A heterogeneous group of HIV-infected patients

María A Navarrete-Muñoz  1   2   3 , Clara Restrepo  1   2 , José M Benito  1   2 , Norma Rallón  1   2
Affiliations
Review

Elite controllers: A heterogeneous group of HIV-infected patients

María A Navarrete-Muñoz et al. Virulence. 2020 Dec.

Abstract

The exceptional group of ECs has been of great help, and will continue to provide invaluable insight with regard to reach a potential functional cure of HIV. However, there is no consensus on the immune correlates associated to this EC phenotype which preclude reaching a potential functional cure of HIV. The existing literature studying this population of individuals has indeed revealed that they are a very heterogeneous group regarding virological, immunological, and even clinical characteristics, and that among ECs only a very small proportion are homogeneous in terms of maintaining virological and immunological control in the long term (the so-called long-term elite controllers, LTECs). Thus, it is of pivotal relevance to identify the LTECs subjects and use them as the right model to redefine immune correlates of a truly functional cure. This review summarizes the evidence of the heterogeneity of HIV elite controllers (ECs) subjects in terms of virological, immunological and clinical outcomes, and the implications of this phenomenon to adequately consider this EC phenotype as the right model of a functional cure.

Keywords: Functional cure; clinical outcomes; elite controllers; heterogeneity; immunological control; virological control.

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Conflict of interest statement

MANM has nothing to disclose; CR has nothing to disclose; JMB has nothing to disclose; NR has nothing to disclose.

Figures

Figure 1.
Figure 1.
Heterogeneity observed in EC subjects (a), highlighting the main factors that can explained it: Level of residual HIV viremia (b); Duration of HIV control (c); Level of immunological control (d); Time to reach EC status (e). Colors in each individual represent the EC heterogeneity. Number of individuals represents the frequency of event in the EC population. Triangles indicate the magnitude of each factor with the narrow end representing the smaller amplitude and the wide end the larger.
Figure 2.
Figure 2.
Factors determining the heterogeneity of EC patients in maintaining virological/immunological control.
See this image and copyright information in PMC

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