Innate Immune Activation in HIV Elite Controllers

A small proportion (<1%) of people who acquire HIV infection maintain normal CD4-cell counts and suppress viral replication below the level of clinical detection without antiretroviral therapy (ART). These so-called “elite controllers” may achieve this status through a favorable genetic background, particularly strong CD8-cell responses to HIV, or both, and they are typically not started on antiretroviral therapy (ART). In general, however, HIV-infected individuals not on ART demonstrate ongoing inflammation and monocyte activation — factors that appear to increase risk for non-AIDS complications, including coronary artery disease (CAD), as well as all-cause mortality. Would elite controllers have similar problems or be more like HIV-uninfe…