Current Treatment Options for HIV Elite Controllers: a Review

Current Treatment Options for HIV Elite Controllers: a Review Opinion statement Initiating antiretroviral therapy (ART) in human immunodeficiency virus (HIV) elite controllers remains controversial, because current evidence does not definitively demonstrate that the benefits of ART outweigh risk in this patient population. However, it is the opinion of the authors that in developed countries, where first-line ART regimens have minimal toxicities, treatment of elite controllers should be strongly considered. Treatment of elite controllers has the potential to minimize the size of the HIV reservoir, which benefits elite controllers who choose to pursue future cure, dampen immune activation, diminish risk of transmission, and encourage linkage and engagement in care allowing HIV providers the opportunity to address HIV-associated non-AIDS conditions and other co-morbidities. Purpose of review This review aims to summarize literature relevant to the manage- ment of elite controllers for clinicians caring for patients living with HIV. Key topics include timing of antiretroviral therapy (ART) and ART in the unique populations of elite controllers with concomitant cardiovascular disease and hepatitis C co-infec- tion, and undergoing immunosuppressive therapy for other co-morbidities. Recent findings The persistent HIV reservoir in elite controllers has two main implications. First, increased immune activation appears to adversely impact clinical outcomes in elite controllers, but the role http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Treatment Options in Infectious Diseases Springer Journals

Current Treatment Options for HIV Elite Controllers: a Review

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Infectious Diseases
eISSN
1534-6250
D.O.I.
10.1007/s40506-018-0158-8
Publisher site
See Article on Publisher Site

Abstract

Opinion statement Initiating antiretroviral therapy (ART) in human immunodeficiency virus (HIV) elite controllers remains controversial, because current evidence does not definitively demonstrate that the benefits of ART outweigh risk in this patient population. However, it is the opinion of the authors that in developed countries, where first-line ART regimens have minimal toxicities, treatment of elite controllers should be strongly considered. Treatment of elite controllers has the potential to minimize the size of the HIV reservoir, which benefits elite controllers who choose to pursue future cure, dampen immune activation, diminish risk of transmission, and encourage linkage and engagement in care allowing HIV providers the opportunity to address HIV-associated non-AIDS conditions and other co-morbidities. Purpose of review This review aims to summarize literature relevant to the manage- ment of elite controllers for clinicians caring for patients living with HIV. Key topics include timing of antiretroviral therapy (ART) and ART in the unique populations of elite controllers with concomitant cardiovascular disease and hepatitis C co-infec- tion, and undergoing immunosuppressive therapy for other co-morbidities. Recent findings The persistent HIV reservoir in elite controllers has two main implications. First, increased immune activation appears to adversely impact clinical outcomes in elite controllers, but the role

Journal

Current Treatment Options in Infectious DiseasesSpringer Journals

Published: Apr 16, 2018

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