What is an elite controller?

Answer 1

In the world of HIV, an 'elite controller' is what is termed a 'long-term non-progressor' .. someone whose immune system, despite being infected with HIV, has been able to successfully suppress the virus to an undetectable level (HIV RNA below 50 copies/ml) for many years, without the help of antiretroviral medications. As the 'elite' prefix probably suggests, this group of people are incredibly rare. Of the millions of people worldwide who are HIV-positive, there are just a few thousand known 'elite controllers'. We have known about the existence of elite controllers for more than a decade and they have been (and continue to be) the subject of a number of studies hat hope to identify whatever naturally occurring immune response these people have .. with the ultimate hope that, once identified, this can somehow be stimulated in everyone who is living with HIV. It is known that, owing to a genetic mutation, a small minority of people of northern European descent have a degree of naturally occurring immunity against HIV (which some have speculated must have developed as a defence against the plague epidemics). The secret of the elite controllers could be related to this, it could be to do with the particular strain of HIV they are infected with, or it could be something else entirely. We simply do not know yet. The discovery of what gives some northern Europeans that degree of natural immunity against HIV has already lead to the development of an entirely new class of HIV drugs called CCR5 inhibitors. The first of these new drugs, maraviroc (marketed as Selzentry in the US, Celsentri in Europe), was licensed in the summer of 2007. The important thing to note is that, with the help of modern medicine, you do not need to be an 'elite controller' in order to be a long term Survivor of HIV and AIDS. Modern antiretroviral treatments administered to a patient with quite advanced HIV infection (including those who have been diagnosed with AIDS) can very often help you to achieve a similar level of suppression in a matter of weeks.