Abstract
Elite controllers (ECs) are an exceptional group of people living with HIV (PLWH) who maintain undetectable viral loads (VLs) despite not being on antiretroviral therapy (ART). However, this phenotype is heterogeneous, with some of these subjects losing virological control over time. In this longitudinal retrospective study, serum acute-phase glycoprotein profile assessed by proton nuclear magnetic resonance (1H-NMR) was determined in 11 transient controllers (TCs) who spontaneously lost virological control and 11 persistent controllers (PCs) who persistently maintained virological control over time. Both PCs and TCs showed similar acute-phase glycoprotein profiles, even when TCs lost the virological control (GlycB, p = 0.824 and GlycA, p = 0.710), and the serum acute-phase glycoprotein signature in PCs did not differ from that in HIV-negative subjects (GlycB, p = 0.151 and GlycA, p = 0.243). Differences in serum glycoproteins A and B were significant only in ECs compared to HIV-typical progressors (TPs) with < 100 CD4+ T-cells (p < 0.001). 1H-NMR acute-phase glycoprotein profile does not distinguish TCs form PCs before the loss of viral control. ECs maintain a low-grade inflammatory state compared to TPs. PCs revealed a closer serum signature to HIV-negative subjects, reaffirming this phenotype as a closer model of functional control of HIV.
Highlights
Elite controllers (ECs) are a select group of people living with HIV (PLWH) who maintain a circulating viral load (VL) at undetectable levels without antiretroviral treatment (ART) [1, 2]
At that time, defined by the loss of control in transient controllers (TCs) subjects, no differences were observed in age, sex, transmission route, HCV coinfection, CD4+ T-cell or CD8+T-cell counts between TCs and persistent controllers (PCs)
We studied the serum glycoprotein profile determined by 1H-NMR in PLWH-EC
Summary
Elite controllers (ECs) are a select group of people living with HIV (PLWH) who maintain a circulating viral load (VL) at undetectable levels without antiretroviral treatment (ART) [1, 2]. This exceptional characteristic makes ECs a good pathogenic model for the functional control of HIV [3, 4]. It was once thought that ECs could have a favorable short- and long-term prognosis, recent real-life data have revealed that ECs are at increased risk of several non-AIDS events [7] It is that most of these events have been pathogenically related to the subclinical low-level inflammatory state due to HIV itself [8]. These molecules are easy to assess but are labile and subject to large variations if new conditions occur; useful, several limitations do exist that decrease their value
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