Plasma Proteomic Profiling Identifies a Subset of HIV Elite Controllers with Inflammatory Profiles Resembling People Without HIV
Background: Elite controllers (ECs) are people with HIV (PWH) who suppress viral replication without antiretroviral therapy (ART). A subset, often termed exceptional elite controllers (EECs), harbor very small viral reservoirs, with few intact proviruses integrated into inactive chromosomal regions. Defining inflammatory signatures in ECs may clarify whether some approach a functionally cured…
Background: People with HIV who suppress the virus without antiretroviral therapy are known as elite controllers. A subset of these, called exceptional elite controllers, have extremely small viral reservoirs. Researchers analyzed plasma proteins in exceptional elite controllers, ART-suppressed non-controllers, and people without HIV to identify inflammatory profiles.
Hierarchical clustering found ECs whose profiles resembled people without HIV, but these ECs were rare in ART-suppressed non-controllers. A distinct subset of ECs showed reduced levels of certain proteins associated with inflammation, such as IL-1β, SCRN1, and BID, and had higher frequencies of protective HLA alleles. Machine-learning analysis showed that these ECs had lower intestinal-associated proteins, higher CD4 counts, and lower pro-inflammatory cytokines.
These findings suggest that identifying this low-inflammatory subset of elite controllers may help understand exceptional HIV control and develop strategies for long-term HIV remission.
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