A new study published in Nature Communications sheds light on the biological mechanisms that allow an extremely rare group of people with HIV—known as “elite controllers”—to keep the virus in their blood at very low or undetectable levels without antiretroviral therapy. Their ability to naturally suppress viral replication, which occurs in less than 1% of people with HIV, has long been of interest to researchers.
In this long-term project, scientists took blood plasma from both “elite controllers” and another group — viremic controllers, who also have relatively low but still measurable levels of the virus — and compared protein profiles using high-precision mass spectrometry and complex bioinformatic analysis. This is reported by the Bioengineer portal.
The results showed that “elite controllers” have characteristic proteins in their plasma associated with immune regulation, inflammation control, and antiviral responses, including pathways involved in the work of natural killer cells and interferon mechanisms. Virulent controllers had different protein signatures, reflecting not only protective responses but also signs of metabolic stress. This indicates different strategies of the body in suppressing the virus: complete suppression of replication versus a situation where it continues at a very low level.
The study also highlights the importance not only of individual proteins, but also of the dynamics of their changes over time, which allows for a better understanding of how natural HIV control works. This approach may help identify biomarkers that predict the body’s ability to keep the virus under control for a long time or, conversely, the risk of an increase in viral load.
In addition to immune mechanisms, proteins associated with metabolic processes and maintaining cell integrity, which may also contribute to natural control of the virus, are attracting attention. Scientists believe that understanding such complex proteomic profiles may open new avenues for developing therapies that mimic the mechanisms of “elite controllers” or for creating vaccines that help the body defend itself more effectively against HIV.
This work not only offers an in-depth insight into how the body can independently suppress HIV, but also lays the foundation for further research that could accelerate the development of new treatments and prediction of the course of infection.
Remember, scientists at Weill Cornell Medicine have discovered new genetic markers that may explain why many people living with HIV, even with good virus control, experience problems with memory, attention, mood, and movement.