HIV Controllers and Long-Term Nonprogressors

Most patients with untreated HIV infection have ongoing viral replication and progressive loss of CD4 cells. However, some patients achieve virologic control or CD4-cell–count stability in the absence of antiretroviral therapy (ART). To find out more about these groups, investigators studied 4586 participants in the U.S. Department of Defense HIV Natural History Study, which has followed HIV-positive individuals in the military healthcare system since 1986.

Elite controllers (ECs; individuals with undetectable HIV RNA levels for ≥1 year in the absence of ART) made up 0.6% of the cohort; viremic controllers (VCs; similar to ECs but with HIV RNA levels 50–2000 copies/mL), 3.3%. Both ECs and VCs had fewer deaths and AIDS-defining illnesses than…