Thirty Years with HIV Infection—Nonprogression Is Still Puzzling: Lessons to Be Learned from Controllers and Long-Term Nonprogressors
In the early days of the HIV epidemic, it was observed that a minority of the infected patients did not progress to AIDS or death and maintained stable CD4+ cell counts. As the technique for measuring viral load became available it was evident that some of these nonprogressors in addition to preserv...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2012-01-01
|
| Series: | AIDS Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2012/161584 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850224791929225216 |
|---|---|
| author | Julie C. Gaardbo Hans J. Hartling Jan Gerstoft Susanne D. Nielsen |
| author_facet | Julie C. Gaardbo Hans J. Hartling Jan Gerstoft Susanne D. Nielsen |
| author_sort | Julie C. Gaardbo |
| collection | DOAJ |
| description | In the early days of the HIV epidemic, it was observed that a minority of the infected patients did not progress to AIDS or death and maintained stable CD4+ cell counts. As the technique for measuring viral load became available it was evident that some of these nonprogressors in addition to preserved CD4+ cell counts had very low or even undetectable viral replication. They were therefore termed controllers, while those with viral replication were termed long-term nonprogressors (LTNPs). Genetics and virology play a role in nonprogression, but does not provide a full explanation. Therefore, host differences in the immunological response have been proposed. Moreover, the immunological response can be divided into an immune homeostasis resistant to HIV and an immune response leading to viral control. Thus, non-progression in LTNP and controllers may be due to different immunological mechanisms. Understanding the lack of disease progression and the different interactions between HIV and the immune system could ideally teach us how to develop a functional cure for HIV infection. Here we review immunological features of controllers and LTNP, highlighting differences and clinical implications. |
| format | Article |
| id | doaj-art-59b997f54f6d4dd1aa2e60d124d0a72e |
| institution | OA Journals |
| issn | 2090-1240 2090-1259 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | AIDS Research and Treatment |
| spelling | doaj-art-59b997f54f6d4dd1aa2e60d124d0a72e2025-08-20T02:05:32ZengWileyAIDS Research and Treatment2090-12402090-12592012-01-01201210.1155/2012/161584161584Thirty Years with HIV Infection—Nonprogression Is Still Puzzling: Lessons to Be Learned from Controllers and Long-Term NonprogressorsJulie C. Gaardbo0Hans J. Hartling1Jan Gerstoft2Susanne D. Nielsen3Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen 2100, DenmarkDepartment of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen 2100, DenmarkDepartment of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen 2100, DenmarkDepartment of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen 2100, DenmarkIn the early days of the HIV epidemic, it was observed that a minority of the infected patients did not progress to AIDS or death and maintained stable CD4+ cell counts. As the technique for measuring viral load became available it was evident that some of these nonprogressors in addition to preserved CD4+ cell counts had very low or even undetectable viral replication. They were therefore termed controllers, while those with viral replication were termed long-term nonprogressors (LTNPs). Genetics and virology play a role in nonprogression, but does not provide a full explanation. Therefore, host differences in the immunological response have been proposed. Moreover, the immunological response can be divided into an immune homeostasis resistant to HIV and an immune response leading to viral control. Thus, non-progression in LTNP and controllers may be due to different immunological mechanisms. Understanding the lack of disease progression and the different interactions between HIV and the immune system could ideally teach us how to develop a functional cure for HIV infection. Here we review immunological features of controllers and LTNP, highlighting differences and clinical implications.http://dx.doi.org/10.1155/2012/161584 |
| spellingShingle | Julie C. Gaardbo Hans J. Hartling Jan Gerstoft Susanne D. Nielsen Thirty Years with HIV Infection—Nonprogression Is Still Puzzling: Lessons to Be Learned from Controllers and Long-Term Nonprogressors AIDS Research and Treatment |
| title | Thirty Years with HIV Infection—Nonprogression Is Still Puzzling: Lessons to Be Learned from Controllers and Long-Term Nonprogressors |
| title_full | Thirty Years with HIV Infection—Nonprogression Is Still Puzzling: Lessons to Be Learned from Controllers and Long-Term Nonprogressors |
| title_fullStr | Thirty Years with HIV Infection—Nonprogression Is Still Puzzling: Lessons to Be Learned from Controllers and Long-Term Nonprogressors |
| title_full_unstemmed | Thirty Years with HIV Infection—Nonprogression Is Still Puzzling: Lessons to Be Learned from Controllers and Long-Term Nonprogressors |
| title_short | Thirty Years with HIV Infection—Nonprogression Is Still Puzzling: Lessons to Be Learned from Controllers and Long-Term Nonprogressors |
| title_sort | thirty years with hiv infection nonprogression is still puzzling lessons to be learned from controllers and long term nonprogressors |
| url | http://dx.doi.org/10.1155/2012/161584 |
| work_keys_str_mv | AT juliecgaardbo thirtyyearswithhivinfectionnonprogressionisstillpuzzlinglessonstobelearnedfromcontrollersandlongtermnonprogressors AT hansjhartling thirtyyearswithhivinfectionnonprogressionisstillpuzzlinglessonstobelearnedfromcontrollersandlongtermnonprogressors AT jangerstoft thirtyyearswithhivinfectionnonprogressionisstillpuzzlinglessonstobelearnedfromcontrollersandlongtermnonprogressors AT susannednielsen thirtyyearswithhivinfectionnonprogressionisstillpuzzlinglessonstobelearnedfromcontrollersandlongtermnonprogressors |