Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
Wall Street Journal - August 17, 2006
Marilyn Chase
Dubbed "elite controllers," these patients' genes are being studied because they may one day yield clues leading to the creation of a vaccine or new class of HIV drugs, said the lead researcher, Bruce D. Walker of Harvard Medical School and the Partners AIDS Research Center of the Massachusetts General Hospital in Boston.
Comprising just one-third of 1% of all people with HIV, elite controllers are a small subset of the previously known group of longstanding HIV-infected people labeled "long term nonprogressors." These nonprogressors -- about 5% to 10% of infected people -- hold virus levels down, and stay well for years although some eventually decline.
The elite controllers have nearly undetectable virus in their blood (defined as 50 or fewer copies of the virus per milliliter of blood). That compares to the rest of the nonprogressors, who also survive for long periods without treatment but whose virus counts go as high as 2,000 copies of the virus per milliliter of blood.
"We're looking at people whose bodies durably live with HIV without it causing a problem," Dr. Walker said. So far he has recruited 150 to 200 elite controllers and plans to compare their health status and immune systems against the larger group of long-term survivors. Eventually, the study aims to compare 1,000 or 2,000 such people in each group.
Asked the source of elite controllers' good fortune, Dr. Walker said it isn't definite but is almost certainly genetic. "We're excited about the possibilities, but sober enough to realize this might not lead to any breakthroughs," he said.
In a separate development at the biennial AIDS confab here, the World Health Organization said patients in developing nations are still woefully underserved but that treatment momentum is starting to build. About 1.65 million people of 24% of the 6.8 million who need antiviral drugs now are actually getting them, up from 1.3 million at the end of 2005, said Kevin De Cock, the WHO's director of AIDS programs. That 24% rate of drug delivery is up from approximately 3% of patients treated just two and a half years ago, Dr. De Cock said.
Write to Marilyn Chase at marilyn.chase@wsj.com
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