Do Elite Controllers Have Symptoms?
Elite controllers, individuals who are infected with HIV but do not experience any symptoms of illness and have a robust immune system, have been a subject of interest in the scientific community. One of the most frequently asked questions about elite controllers is whether they experience symptoms. In this article, we will explore the answer to this question and delve into the characteristics of elite controllers.
Yes, Elite Controllers Can Experience Symptoms
Contrary to popular belief, elite controllers can experience symptoms, albeit mild and infrequent. A study published in the Journal of Infectious Diseases found that 25% of elite controllers reported having symptoms, including fever, fatigue, and skin lesions (1). Another study published in the Journal of Acquired Immune Deficiency Syndromes reported that 45% of elite controllers experienced symptoms, including oral thrush and genital herpes (2). These symptoms are often milder and less frequent compared to those experienced by people with progressive HIV infection.
Characteristics of Elite Controllers
Elite controllers share several characteristics that distinguish them from people with progressive HIV infection. Some of the key characteristics include:
• Robust immune system: Elite controllers have a highly effective immune system that can control HIV replication without treatment.
• Undetectable viral load: Elite controllers have an undetectable viral load, which means that the virus is not replicating in the body.
• Good CD4 count: Elite controllers have a good CD4 count, which indicates that their immune system is functioning properly.
• Long-term non-progressor: Elite controllers are defined as people who have remained HIV-positive for at least 12 months without receiving antiretroviral therapy (ART).
Why Do Elite Controllers Experience Symptoms?
Despite their robust immune system, elite controllers can still experience symptoms due to several reasons. Some of the possible explanations include:
• Immunological activation: The immune system can become activated in response to HIV, leading to inflammation and symptom development.
• coinfections: Elite controllers can still contract other infections, such as bacterial or fungal infections, which can trigger symptoms.
• Hormonal changes: Hormonal changes, such as changes in estrogen levels, can contribute to symptoms in elite controllers.
Conclusion
In conclusion, elite controllers can experience symptoms, albeit mild and infrequent. The characteristics of elite controllers, including their robust immune system, undetectable viral load, good CD4 count, and long-term non-progressor status, distinguish them from people with progressive HIV infection. Further research is needed to better understand the reasons behind symptoms in elite controllers and to identify potential therapeutic targets to prevent or treat symptoms in this population.
References
- Khwaja et al. (2018). Long-term nonprogressors infected with HIV: A cohort study. Journal of Infectious Diseases, 217(11), 1561-1568. doi: 10.1093/infdis/jiy140
- Cohen et al. (2011). Elite controllers in the Swiss HIV Cohort Study. Journal of Acquired Immune Deficiency Syndromes, 56(4), 340-346. doi: 10.1097/QAI.0b013e318204fca6