Have you ever heard about elite controllers? This is the person whose immune system is strong enough to supress the HIV viral load without the need for medications. According to current estimates one out of 200 people who are HIV positive is an elite controller.
So, how do their bodies work? Can that mechanism be used to develop a cure for HIV and AIDS? A recent study has tried to discover these answers.
The Elite Controllers Study
Ragon Institute researchers recently published the results of their latest study that explores the manner in which elite controllers handle the viral load after becoming HIV-positive.
The study involved 64 HIV-positive individuals classified as elite controllers. Researchers took samples of their T-cells – the ones that the HIV virus attacks upon entering the human body. Out of a billion samples, the researchers could not find replication-competent HIV genetic material. In addition, the researchers could not grow or replicate any HIV through these T-cells.
This is an astounding finding. It suggests that dynamic, complex processes occur in the bodies of elite controllers to kill off the cells that are most likely to produce active HIV.
As per the study conclusion, this is a completely natural, immune-modulated mechanism. It’s still too early to tell, however, whether such information can be used for the development of highly effective HIV vaccines and cures.
In essence, elite controllers are self-curing themselves by a very intricate and specific immune response.
Current estimates suggest that they represent 0.5 per cent of the HIV-positive population of the world. For years, they manage to maintain undetectable loads without requiring antiretroviral therapy.
Important New Findings
The scientific community has had some understanding of how elite controller bodies work. The new study, however, provides a few additional pieces of information that will eventually help medics and pharmaceutical developers complete the puzzle.
According to the new study, elite controllers limit HIV genetic material replication in a very complex way.
HIV has its own transcription factors used for the replication of the viral DNA. It needs to integrated into human DNA to switch on other genes that are required to initiate the viral transcription process. This means that HIV is dependent on their host and the human genetics to successfully infiltrate the immune system.
In the new study, researchers found out that in elite controllers, HIV genes are found barren areas of chromatin that have been labelled gene deserts. What this means is that the virus is denied access to the parts of the human genetic code required for its successful multiplication.
Researchers believe that in elite controllers, the virus has not stumbled upon these gene deserts accidentally. Rather, the immune system itself “blocks” the virus from reaching genetically fertile ground required for its replication.
The study findings suggest that up to 60 per cent of the HIV genetic material discovered in the body of elite controllers is focused within these so-called gene deserts.
Who Are the Elite Controllers?
In the study, academics also tried to discover some defining characteristics that could make elite controllers easier to identify.
The study group of elite controllers was compared to another sample of HIV-positive individuals who needed medications to keep their viral load under control.
The two groups had the same proportions of men to women, they had undetectable viral load for about nine years and they’d been infected with HIV for the same length of time.
Elite controllers were found out to have higher CD4 counts than other HIV-positive individuals. Those who were on antiretroviral therapy also had about 20 times as many T-cells containing HIV DNA as the elite controllers.
A previous study, however, suggests that there are no consistent demographic patterns and characteristics that could be used to pinpoint elite controllers. There are also no differences between controllers and non-controllers in terms of the mode of HIV transmission.
A Step Closer to the Successful Treatment of HIV
Many researchers believe that elite controllers hold the clue for the development of HIV vaccines and treatments that will eliminate the virus altogether.
Previously, it was believed that the availability of intact HIV genes in the human body could contribute to the activation of the infection at any given point of time. The new study, however, shows how intricate the interaction of the virus with the human DNA is. In the absence of supportive human genes, HIV is entirely incapable of replicating itself.
The study provides a functional blueprint for the potential formulation of an innovative HIV cure in the future. Using this mechanism, it will become pointless to get rid of all intact HIV sequences in the patient’s genome. It would simply be a matter of targeting those located within active parts of the genome that allow the proliferation of the virus.
At the time being, however, we still have a long way to go.
Until vaccines get developed, it’s still essential to go through regular HIV testing. Relying on preventative products like HIV PrEP and HIV PEP can also bring down the risk of infection significantly among those that have potentially been exposed.
If you are interested in finding out more about HIV screening, prevention and prophylaxis, please visit a STD clinic in Singapore like Shim Clinic. At Shim Clinic, you’ll get a thorough consultation to have your questions answered, you’ll get a chance to test yourself and to learn more about the treatment options that can be used to successfully control the viral load.
- Jiang, C. (2020, August 26). Distinct viral reservoirs in individuals with spontaneous control of HIV-1. Nature Journal. https://www.nature.com/articles/s41586-020-2651-8?error=cookies_not_supported&code=d44fcd17-e517-4c8c-a237-fafa87ee7a95
- Considerations for the clinical management of HIV elite controllers | The Ontario HIV Treatment Network. (2018, July 26). Ontario HIV Treatment Network. https://www.ohtn.on.ca/rapid-response-considerations-for-the-clinical-management-of-hiv-elite-controllers/#:%7E:text=Exact%20definition%20of%20elite%20control,measurements%20over%2010%20years%20(2%2C