The Esperanza Patient: More Hope for a Sterilizing HIV-1 Cure
Authors: Joel N. Blankson
Journal: Annals of Internal Medicine (2021)

EditorialsJanuary 2022The Esperanza Patient: More Hope for a Sterilizing HIV-1 CureJoel N. Blankson, MD, PhDJoel N. Blankson, MD, PhDCenter for AIDS Research, Department of Medicine, Johns Hopkins Medicine, Baltimore, MarylandAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-4336 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Fewer than 1% of people living with HIV are able to control viral replication to below the limits of detection by commercial assays without antiretroviral therapy (ART). These patients are called "elite controllers" or "elite suppressors," and they represent a model of a cure for HIV-1 (1). However, it has not always been clear whether they are models of a functional cure, where replication-competent virus remains but is controlled by host factors (analogous to the control of herpes viruses), or a sterilizing cure, where the virus is eradicated by the host (analogous to the control of most viruses).In order ...References1. Li JZ, Blankson JN. How elite controllers and posttreatment controllers inform our search for an HIV-1 cure. J Clin Invest. 2021;131. [PMID: 34060478] doi:10.1172/JCI149414 CrossrefMedlineGoogle Scholar2. Salgado M, Swanson MD, Pohlmeyer CW, et al. HLA-B*57 elite suppressor and chronic progressor HIV-1 isolates replicate vigorously and cause CD4+ T cell depletion in humanized BLT mice. J Virol. 2014;88:3340-52. [PMID: 24390323] doi:10.1128/JVI.03380-13 CrossrefMedlineGoogle Scholar3. Woldemeskel BA, Kwaa AK, Blankson JN. Viral reservoirs in elite controllers of HIV-1 infection: implications for HIV cure strategies. EBioMedicine. 2020;62:103118. [PMID: 33181459] doi:10.1016/j.ebiom.2020.103118 CrossrefMedlineGoogle Scholar4. Kwaa AK, Garliss CC, Ritter KD, et al. Elite suppressors have low frequencies of intact HIV-1 proviral DNA [Letter]. AIDS. 2020;34:641-3. [PMID: 31895150] doi:10.1097/QAD.0000000000002474 CrossrefMedlineGoogle Scholar5. Jiang C, Lian X, Gao C, et al. Distinct viral reservoirs in individuals with spontaneous control of HIV-1. Nature. 2020;585:261-7. [PMID: 32848246] doi:10.1038/s41586-020-2651-8 CrossrefMedlineGoogle Scholar6. Pinzone MR, Weissman S, Pasternak AO, et al. Naive infection predicts reservoir diversity and is a formidable hurdle to HIV eradication. JCI Insight. 2021;6. [PMID: 34228640] doi:10.1172/jci.insight.150794 CrossrefMedlineGoogle Scholar7. Mendoza D, Johnson SA, Peterson BA, et al. Comprehensive analysis of unique cases with extraordinary control over HIV replication. Blood. 2012;119:4645-55. [PMID: 22490332] doi:10.1182/blood-2011-10-381996 CrossrefMedlineGoogle Scholar8. Uruena A, Cassetti I, Kashyap N, et al. Prolonged posttreatment virologic control and complete seroreversion after advanced human immunodeficiency virus-1 infection. Open Forum Infect Dis. 2021;8:ofaa613. [PMID: 33511235] doi:10.1093/ofid/ofaa613 CrossrefMedlineGoogle Scholar9. Turk G, Seiger K, Lian X, et al. A possible sterilizing cure of HIV-1 infection without stem cell transplantation. Ann Intern Med. 2022;175:95-100. doi:10.7326/L21-0297 Google Scholar10. Jilg N, Li JZ. On the road to a HIV cure: moving beyond Berlin and London. Infect Dis Clin North Am. 2019;33:857-68. [PMID: 31395147] doi:10.1016/j.idc.2019.04.007 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Center for AIDS Research, Department of Medicine, Johns Hopkins Medicine, Baltimore, MarylandDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-4336.Corresponding Author: Joel N. Blankson, MD, PhD, Center for AIDS Research, Department of Medicine, Johns Hopkins Medicine, 855 North Wolfe Street, Baltimore, MD 21205; e-mail, [email protected]edu.This article was published at Annals.org on 16 November 2021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Possible Sterilizing Cure of HIV-1 Infection Without Stem Cell Transplantation Gabriela Turk , Kyra Seiger , Xiaodong Lian , Weiwei Sun , Elizabeth M. Parsons , Ce Gao , Yelizaveta Rassadkina , Maria Laura Polo , Alejandro Czernikier , Yanina Ghiglione , Alejandra Vellicce , Joseph Varriale , Jun Lai , Yuko Yuki , Maureen Martin , Ajantha Rhodes , Sharon R. Lewin , Bruce D. Walker , Mary Carrington , Robert Siliciano , Janet Siliciano , Mathias Lichterfeld , Natalia Laufer , and Xu G. Yu Metrics January 2022Volume 175, Issue 1Page: 135-136KeywordsAntiretroviral therapyBlood plasmaDNAHIV-1RNAT cellsViral load ePublished: 16 November 2021 Issue Published: January 2022 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...