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Case report: mechanisms of HIV elite control in two African women

Overview of attention for article published in BMC Infectious Diseases, January 2018
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4 tweeters
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1 Facebook page

Citations

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31 Dimensions

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48 Mendeley
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Title
Case report: mechanisms of HIV elite control in two African women
Published in
BMC Infectious Diseases, January 2018
DOI 10.1186/s12879-018-2961-8
Pubmed ID
Authors

Yumna Moosa, Ramla F. Tanko, Veron Ramsuran, Ravesh Singh, Mashudu Madzivhandila, Nonhlanhla Yende-Zuma, Melissa-Rose Abrahams, Philippe Selhorst, Kamini Gounder, Penny L. Moore, Carolyn Williamson, Salim S. Abdool Karim, Nigel J. Garrett, Wendy A. Burgers

Abstract

The majority of people living with HIV require antiretroviral therapy (ART) for controlling viral replication, however there are rare HIV controllers who spontaneously and durably control HIV in the absence of treatment. Understanding what mediates viral control in these individuals has provided us with insights into the immune mechanisms that may be important to induce for a vaccine or functional cure for HIV. To date, few African elite controllers from high incidence settings have been described. We identified virological controllers from the CAPRISA 002 cohort of HIV-1 subtype C infected women in KwaZulu Natal, South Africa, two (1%) of whom were elite controllers. We examined the genetic, clinical, immunological and virological characteristics of these two elite HIV controllers in detail, to determine whether they exhibit features of putative viral control similar to those described for elite controllers reported in the literature. In this case report, we present clinical features, CD4+ T cell and viral load trajectories for two African women over 7 years of HIV infection. Viral load became undetectable 10 months after HIV infection in Elite Controller 1 (EC1), and after 6 weeks in Elite Controller 2 (EC2), and remained undetectable for the duration of follow-up, in the absence of ART. Both elite controllers expressed multiple HLA Class I and II haplotypes previously associated with slower disease progression (HLA-A*74:01, HLA-B*44:03, HLA-B*81:01, HLA-B*57:03, HLA-DRB1*13). Fitness assays revealed that both women were infected with replication competent viruses, and both expressed higher mRNA levels of p21, a host restriction factor associated with viral control. HIV-specific T cell responses were examined using flow cytometry. EC1 mounted high frequency HIV-specific CD8+ T cell responses, including a B*81:01-restricted Gag TL9 response. Unusually, EC2 had evidence of pre-infection HIV-specific CD4+ T cell responses. We identified some features typical of elite controllers, including high magnitude HIV-specific responses and beneficial HLA. In addition, we made the atypical finding of pre-infection HIV-specific immunity in one elite controller, that may have contributed to very early viral control. This report highlights the importance of studying HIV controllers in high incidence settings.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 48 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 48 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 9 19%
Student > Bachelor 5 10%
Student > Ph. D. Student 5 10%
Student > Doctoral Student 4 8%
Student > Postgraduate 3 6%
Other 11 23%
Unknown 11 23%
Readers by discipline Count As %
Medicine and Dentistry 9 19%
Biochemistry, Genetics and Molecular Biology 8 17%
Immunology and Microbiology 7 15%
Agricultural and Biological Sciences 5 10%
Nursing and Health Professions 4 8%
Other 2 4%
Unknown 13 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 March 2018.
All research outputs
#8,890,362
of 15,159,747 outputs
Outputs from BMC Infectious Diseases
#2,572
of 5,575 outputs
Outputs of similar age
#179,720
of 363,790 outputs
Outputs of similar age from BMC Infectious Diseases
#1
of 1 outputs
Altmetric has tracked 15,159,747 research outputs across all sources so far. This one is in the 39th percentile – i.e., 39% of other outputs scored the same or lower than it.
So far Altmetric has tracked 5,575 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.1. This one has gotten more attention than average, scoring higher than 50% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 363,790 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them