Long-term nonprogressor

Long-term nonprogressors (LTNPs), individuals who are infected with HIV, but maintain a CD4 count greater than 500 without antiretroviral therapy with a detectable viral load.[1] Many of these patients have been HIV positive for 30 years without progressing to the point of needing to take medication in order not to develop AIDS. They have been the subject of a great deal of research, since an understanding of their ability to control HIV infection may lead to the development of immune therapies or a therapeutic vaccine.[2] The classification "Long-term non-progressor" is not permanent, because some patients in this category have gone on to develop AIDS.

Long-term nonprogressors typically have viral loads under 10,000 copies RNA/ml blood,[3] do not take antiretrovirals, and have CD4+ counts within the normal range.[4] Most people with HIV not on medication have viral loads which are much higher.

It is estimated that around 1 in 300 people with HIV are long-term nonprogressors.[5] Without the symptoms of AIDS, many LTNP patients may not know they are infected.[6]

Genetic traits that confer greater resistance or more robust immune response to HIV are thought to explain why LTNP patients are able to live much longer with HIV than patients who are not LTNP.[7][8] Some LTNP are infected with a weakened or inactive form of HIV, but it is now known that many LTNP patients carry a fully virulent form of the virus. Genetic traits that may affect progression include:

References

  1. http://www.aidsmap.com/HIV-non-progressor-status-established-soon-after-infection/page/1432975/
  2. Understanding Long-term Nonprogressors. International AIDS Vaccine Initiative. accessed Dec 2007. Archived October 9, 2006 at the Wayback Machine
  3. Poropatich, Kate; Sullivan, David J. (2010). "Human immunodeficiency virus type 1 long-term non-progressors: the viral, genetic and immunological basis for disease non-progression". Journal of General Virology 92 (2). doi:10.1099/vir.0.027102-0.
  4. Rhodes DI, Ashton L, Solomon A, Carr A, Cooper D, Kaldor J, Deacon N (November 2000). "Characterization of three nef-defective human immunodeficiency virus type 1 strains associated with long-term nonprogression. Australian Long-Term Nonprogressor Study Group". J. Virol. 74 (22): 10581–8. doi:10.1128/jvi.74.22.10581-10588.2000. PMC 110932. PMID 11044102. Retrieved 2010-10-13.
  5. National Institute of Allergy and Infectious Diseases, http://www.niaid.nih.gov/volunteer/hivlongterm/Pages/default.aspx, accessed July 5, 2011
  6. Walker BD (2007). "Elite control of HIV Infection: implications for vaccines and treatment". Top HIV Med. 15 (4): 134–6. PMID 17720999.
  7. O’connell, K. A.; Bailey, J. R.; Blankson, J. N. (2009). "Elucidating the elite: mechanisms of control in HIV-1 infection". Trends in Pharmacological Sciences 30 (12): 631–637. doi:10.1016/j.tips.2009.09.005. PMID 19837464.
  8. Blankson, J. N. (2009). "Effector mechanisms in HIV-1 infected elite controllers: Highly active immune responses?". Antiviral Research 85 (1): 295–302. doi:10.1016/j.antiviral.2009.08.007. PMC 2814919. PMID 19733595.
  9. 1 2 http://journals.lww.com/aidsonline/Fulltext/2006/03210/A_nonsense_mutation__428G__A__in_the.7.aspx
  10. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1315998/?tool=pubmed
  11. Hendrickson, S. L.; Hutcheson, H. B.; Ruiz-Pesini, E.; Poole, J. C.; Lautenberger, J.; Sezgin, E.; Kingsley, L.; Goedert, J. J.; Vlahov, D.; Donfield, S.; Wallace, D. C.; OʼBrien, S. J. (2008-11-30). "Mitochondrial DNA haplogroups influence AIDS progression". AIDS 22 (18): 2429–2439. doi:10.1097/QAD.0b013e32831940bb. ISSN 0269-9370. PMC 2699618. PMID 19005266.
  12. Lambotte Olivier, Boufassa Faroudy, Madec Yoann, Nguyen Ahn; et al. (2005). "HIV controllers: a homogeneous group of HIV-1-infected patients with spontaneous control of viral replication". Clinical Infectious Diseases 41 (7): 1053–6. doi:10.1086/433188. PMID 16142675.
  13. Migueles, S. A.; Sabbaghian, M. S.; Shupert, W. L.; Bettinotti, M. P.; Marincola, F. M.; Martino, L.; Hallahan, C. W.; Selig, S. M.; Schwartz, D.; Sullivan, J.; Connors, M. (2000-02-29). "HLA B*5701 is highly associated with restriction of virus replication in a subgroup of HIV-infected long term nonprogressors". Proceedings of the National Academy of Sciences 97 (6): 2709–2714. doi:10.1073/pnas.050567397. ISSN 0027-8424. PMC 15994. PMID 10694578.
  14. Costello, C.; Tang, J.; Rivers, C.; Karita, E.; Meizen-Derr, J.; Allen, S.; Kaslow, R. A. (1999-10-01). "HLA-B*5703 independently associated with slower HIV-1 disease progression in Rwandan women". AIDS 13 (14): 1990–1991. doi:10.1097/00002030-199910010-00031. PMID 10513667. Retrieved 2013-06-12.
  15. Almeida, J. R.; Price, D. A.; Papagno, L.; Arkoub, Z. A.; Sauce, D.; Bornstein, E.; Asher, T. E.; Samri, A.; Schnuriger, A.; Theodorou, I.; Costagliola, D.; Rouzioux, C.; Agut, H.; Marcelin, A.-G.; Douek, D.; Autran, B.; Appay, V. (2007-09-24). "Superior control of HIV-1 replication by CD8+ T cells is reflected by their avidity, polyfunctionality, and clonal turnover". Journal of Experimental Medicine 204 (10): 2473–2485. doi:10.1084/jem.20070784. ISSN 0022-1007.
  16. http://www.newscientist.com/article/dn24426-virussabotaging-protein-may-help-people-defy-hiv.html

12. "Delineating Antibody Recognition in Polyclonal Sera from Patterns of HIV-1 Isolate Neutralization" http://www.sciencemag.org/content/340/6133/751.abstract

External links

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