HIV control: Is getting there the same as staying there?
In this brief review and perspective, we address the question of whether the immune responses that bring about immune control of acute HIV infection are the same as, or distinct from, those that maintain long-term viral suppression once control of viremia has been achieved. To this end, we describe...
| Main Authors: | , |
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| Format: | Journal article |
| Language: | English |
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Public Library of Science
2018
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| _version_ | 1797104338999443456 |
|---|---|
| author | Goulder, P Deeks, SG |
| author_facet | Goulder, P Deeks, SG |
| author_sort | Goulder, P |
| collection | OXFORD |
| description | In this brief review and perspective, we address the question of whether the immune responses that bring about immune control of acute HIV infection are the same as, or distinct from, those that maintain long-term viral suppression once control of viremia has been achieved. To this end, we describe the natural history of elite and post-treatment control, noting the lack of data regarding what happens acutely. We review the evidence suggesting that the two clinical phenotypes may differ in terms of the mechanisms required to achieve and maintain control, as well as the level of inflammation that persists once a steady state is achieved. We then describe the evidence from longitudinal studies of controllers who fail and studies of biologic sex (male versus female), age (children versus adults), and simian immunodeficiency virus (SIV) (pathogenic/experimental versus nonpathogenic/natural infection). Collectively, these studies demonstrate that the battle between the inflammatory and anti-inflammatory pathways during acute infection has long-term consequences, both for the degree to which control is maintained and the health of the individual. Potent and stringent control of HIV may be required acutely, but once control is established, the chronic inflammatory response can be detrimental. Interventional approaches designed to bring about HIV cure and/or remission should be nuanced accordingly. |
| first_indexed | 2024-03-07T06:32:24Z |
| format | Journal article |
| id | oxford-uuid:f6724558-cf44-4879-9a3b-7d832d09f3b3 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:32:24Z |
| publishDate | 2018 |
| publisher | Public Library of Science |
| record_format | dspace |
| spelling | oxford-uuid:f6724558-cf44-4879-9a3b-7d832d09f3b32022-03-27T12:35:16ZHIV control: Is getting there the same as staying there?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f6724558-cf44-4879-9a3b-7d832d09f3b3EnglishSymplectic Elements at OxfordPublic Library of Science2018Goulder, PDeeks, SGIn this brief review and perspective, we address the question of whether the immune responses that bring about immune control of acute HIV infection are the same as, or distinct from, those that maintain long-term viral suppression once control of viremia has been achieved. To this end, we describe the natural history of elite and post-treatment control, noting the lack of data regarding what happens acutely. We review the evidence suggesting that the two clinical phenotypes may differ in terms of the mechanisms required to achieve and maintain control, as well as the level of inflammation that persists once a steady state is achieved. We then describe the evidence from longitudinal studies of controllers who fail and studies of biologic sex (male versus female), age (children versus adults), and simian immunodeficiency virus (SIV) (pathogenic/experimental versus nonpathogenic/natural infection). Collectively, these studies demonstrate that the battle between the inflammatory and anti-inflammatory pathways during acute infection has long-term consequences, both for the degree to which control is maintained and the health of the individual. Potent and stringent control of HIV may be required acutely, but once control is established, the chronic inflammatory response can be detrimental. Interventional approaches designed to bring about HIV cure and/or remission should be nuanced accordingly. |
| spellingShingle | Goulder, P Deeks, SG HIV control: Is getting there the same as staying there? |
| title | HIV control: Is getting there the same as staying there? |
| title_full | HIV control: Is getting there the same as staying there? |
| title_fullStr | HIV control: Is getting there the same as staying there? |
| title_full_unstemmed | HIV control: Is getting there the same as staying there? |
| title_short | HIV control: Is getting there the same as staying there? |
| title_sort | hiv control is getting there the same as staying there |
| work_keys_str_mv | AT goulderp hivcontrolisgettingtherethesameasstayingthere AT deekssg hivcontrolisgettingtherethesameasstayingthere |