Elite controllers: A heterogeneous group of HIV-infected patients

Figures & data

Figure 1. Heterogeneity observed in EC subjects (a), highlighting the main factors that can explained it: Level of residual HIV viremia (b); Duration of HIV control (c); Level of immunological control (d); Time to reach EC status (e). Colors in each individual represent the EC heterogeneity. Number of individuals represents the frequency of event in the EC population. Triangles indicate the magnitude of each factor with the narrow end representing the smaller amplitude and the wide end the larger.

Table 1. Studies addressing the time-to-reach EC status.

Seroconverter Cohorts	Number of patients in the cohort	EC patients	% EC	Median delay to reach virological control (months)	Virological control period (years)	References
CASCADE	9896	140/9896	1.4	17	>5	[11]
	2176	145/2176	6.7	23	<1	[17]
US Department of Defense HIV Natural History Study	4621	17*/4621	0.4	12	2.3**	[18]
Primary/Acute HIV infection Cohorts	Number of patients in the cohort	EC patients	% EC	Median delay to reach virological control (months)	Virological control period (years)	References
ANRS CO06 PRIMO	211	8/211	3.8	6.2	>1	[20]
AIEDRP network	98	6/98	6.1	6.6	-	[19]

*25 EC patients were identified in this cohort, of which 17 had a known date of seroconversion ** Median of virological control duration (years), including all elite controllers, not only seroconverts (n = 25).

Table 2. Studies addressing the duration of virological control.

Seroconversion or Primary/acute HIV infection
Cohort	HIV-patients included	EC patients	% EC	Virologic control period (years)	Median follow-up (years)	References
Centre Hospitalo- Universitaire de Bicetre and SEROCO-HEMOCO	2851	15/2851	0.6	10	10	[4]
CASCADE	9896	140/9896	1.4	85% EC >13	13.3	[11]
	2176	145/2176	6.7	0.9	6.6	[17]
US Department of Defense HIV Natural History Study	4621	17*/4621	0.4	2.3**	7.8	[18]
ANRS CO06 PRIMO	211	8/211	3.8	4.1	5.8	[20]
Chronic HIV infection
Cohort	HIV-patients included	EC patients	% EC	Virologic control period (years)	Median follow-up (years)	References
Evelyn Jordan Center, Baltimore Veterans Administration (VA), and Maryland General Hospital	-	40	-	6.7	14	[21]
ECRIS	13,371	204/13,371	1.5	6.2	14.9	[7]
ANRS	46,880	69/46,880	0.15	>10	>10	[12]

*25 EC patients were identified in this cohort, of which 17 had a known date of seroconversion ** Median of virological control duration (years), including all elite controllers, not only seroconverts (n = 25).

Figure 2. Factors determining the heterogeneity of EC patients in maintaining virological/immunological control.

Table 3. Studies addressing the loss of immunological control.

Cohort	HIV-patients included	EC patients	% EC	Virological control period (years)	% EC with immune control loss	Cause	References
CASCADE	2176	145/2176	6.7	0.9	3.4	-	[17]
ANRS CO06 PRIMO	211	8/211	3.8	4.1	0	-	[20]
US Department of Defense HIV Natural History Study	4621	17/4621	0.4	2.3	4	-	[18]
ANRS EP36	34,317	81/34,317	0.3	10	62.3	Viral blips	[10]
Boston hospitals	-	90	-	3.6	8.9	High residual plasma viremia	[13]
CO18/CO21 CODEX	-	217	-	5	4.6	High residual plasma viremia, HIV-DNA, cell activation, viral blips and lower CD4 nadir	[8]
ECRIS	13,371	204/13,371	1.5	6.2	44.1	Sexual acquisition of HIV and lower CD4 nadir	[7]

Table

cART	combination antiretroviral therapy
AIDS	acquired immune deficiency syndrome
HIV	human immunodeficiency virus
DNA	deoxyribonucleic acid
RNA	ribonucleic acid
EC	elite controller
LTEC	long-term elite controller
CD4	cluster of differentiation 4
CD8	cluster of differentiation 8
nADEs	non-AIDS defining events

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