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Current Treatment Options for HIV Elite Controllers: a Review
Katherine Promer1, Maile Y Karris1
1Department of Medicine, University of California San Diego, 200 West Arbor Drive #8681, San Diego, CA, 92103, USA.
Current Treatment Options in Infectious Diseases
|October 23, 2018
Summary
Initiating antiretroviral therapy (ART) for human immunodeficiency virus (HIV) elite controllers is debated. However, ART may reduce the HIV reservoir, decrease immune activation, and lower transmission risk, warranting consideration in developed nations.
Area of Science:
- Immunology
- Virology
- Clinical Medicine
Background:
- Elite controllers maintain spontaneous control of human immunodeficiency virus (HIV) without antiretroviral therapy (ART).
- The decision to initiate ART in elite controllers is complex due to potential risks and benefits.
Purpose of the Study:
- To review the literature on managing elite controllers, focusing on ART initiation.
- To discuss ART considerations in elite controllers with co-morbidities like cardiovascular disease and hepatitis C.
Main Methods:
- Literature review of studies on elite controllers and ART.
- Analysis of factors influencing ART timing and outcomes.
Main Results:
- The HIV reservoir in elite controllers can lead to increased immune activation, potentially impacting clinical outcomes.
- Elite control can be transient, necessitating monitoring for disease progression and ART timing.
Conclusions:
- ART initiation in elite controllers remains controversial, despite theoretical advantages.
- Optimal management requires balancing ART risks and benefits, alongside monitoring immune activation.
- Considering ART for elite controllers in developed countries with low-toxicity regimens is advisable.
Keywords:
Antiretroviral therapyCardiovascular diseaseElite controllersHIVHepatitis CImmunosuppressionTreatment optionsMore Related Videos
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