Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Retrovirology. 2011 Aug 3;8:63. doi: 10.1186/1742-4690-8-63.
Elite suppressors or controllers (ES) are HIV-1 infected patients who maintain undetectable viral loads without treatment. While HLA-B57-positive ES are usually infected with virus that is unmutated at CTL epitopes, a single, dominant variant containing CTL escape mutations is typically seen in plasma during chronic infection. We describe an ES who developed seven distinct and rare escape variants at an HLA-B57-restricted Gag epitope over a five year period. Interestingly, he developed proliferative, de novo CTL responses that suppressed replication of each of these variants. These responses, in combination with low viral fitness of each variant, may contribute to sustained elite control in this ES.
精英控制者（ES）是指未经治疗就能将病毒载量控制在检测不到水平的 HIV-1 感染者。虽然 HLA-B57 阳性的 ES 通常感染的病毒在 CTL 表位处未发生突变，但在慢性感染期间，通常在血浆中可观察到单一、占主导地位的包含 CTL 逃逸突变的变异株。我们描述了一位 ES 患者，在五年的时间里，在 HLA-B57 限制的 Gag 表位上出现了七种不同的罕见逃逸变异株。有趣的是，他产生了增殖性、新出现的 CTL 反应，抑制了每种变异株的复制。这些反应，加上每种变异株的低病毒适应性，可能有助于该 ES 持续的精英控制。
