Oct 31, 2010
Greetings Dr Holodniy, I do not know exactly what forum my ? belongs but from reading many of your responses I see you are extremely knowledgable and respect your expertise(no disrespect to the other great Drs here intended). So....Infected in '86, CD4s 500-750, VL Ud w/o meds. In Elite Controllers it appears the mechanism by which we control viral replication is the cell-mediated immunity(CD8s). Am I correct? What role if any does the humoral system play? Also, with assays now available that are able to quantify down to 1 copy have any studies been done on ECs to see if there is any replication going on at all in their bodies? Thank You Sir
Response from Dr. Holodniy
Yes, the CD8 response is increased and more efficient in elite controllers compared to those who are HIV infected and whose virus is not controlled or controlled with HIV meds. The Humoral system is also important. B cells, which make antibodies, still have a role to play in helping control infection. Although many controllers do have some level of virus in plasma below 50 copies, they also have copies of integrated virus in circulating mature CD4 cells, albeit much less than those whose infection is not controlled or controlled by HIV meds.
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