Transmission of Human Immunodeficiency Virus Type 1 from a Patient Who Developed AIDS to an Elite Suppressor

Abstract
Elite suppressors (ES) are untreated human immunodeficiency virus type 1 (HIV-1)-infected patients who maintain viral loads of + T-cell response in the ES appears to have prevented viral replication and thus the evolution toward a more fit variant. In addition, CD8 + T cells in the ES have selected for a rare mutation in an immunodominant HLA-B*27-restricted Gag epitope, which also has a negative impact on fitness. The results strongly suggest that through direct and indirect mechanisms, CD8 + T cells in some ES control HIV-1 isolates are capable of causing profound immunosuppression.

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