A group of American scientists has come closer to solving the mystery of so-called ‘elite controllers’ (ECs) – a rare group of people who are able to keep low levels of HIV without antiretroviral drugs.
Researchers from the National Institutes of Health compared “chromosomal integration sites and escape mutations” of 58 ‘elite controllers’ and 42 individuals on antiretroviral therapy (ART) “to understand the role of immune pressure.”
The tests showed that elite controllers demonstrated “effective cellular immune responses” that make “durable drug-free control” of virus replication possible.
Moreover, the scientists found that the viral genetic sequences in ECs tend to stay in small and remote chromosomes’ ‘reservoirs’, which possibly reduces their capacity to replicate.
“Together, these results suggest a distinct signature of immune footprints in proviral sequences from EСs,” the study said.
According to the World Health Organization’s 2020 figures, there are more than 37.7 million HIV-infected people worldwide. For more than 99% of them ART is the only way to control the virus.
Understanding the mechanisms of elite controllers’ capacity to ‘self-cure’ could help to develop new therapies for the ART-dependent patients.
However, these mechanisms are very difficult to establish. According to Satya Dandekar, a HIV researcher at the University of California, the problem is related to the fact that the first ‘meetings’ of HIV with the ECs’ immune systems have not been recorded.
“We miss the initial punches the immune system has thrown at the virus,” Dandekar explained, as quoted by Science News.
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