[HIV controllers: a homogeneous group of HIV-1 infected patients with a spontaneous control of viral replication]

Abstract

We identified a group of chronically HIV-1-infected patients in whom viral replication is spontaneously controlled without antiretroviral treatment. These patients account for less than 1% of HIV-infected patients. They are defined according to a virological definition: plasma viral load less than 400 copies RNA/ml in more than 90% of the samples tested and HIV positive serology known for more than 10 years. They should never have received antiretroviral therapy. The CD4 T cell count is not taken into account, which differenciate these patients from long-term non progressors. Fifteen patients HIV controllers have been studied in a preliminary work with two main results: i) the demonstration of a strong HIV-specific CD8 immune response and ii) the amount of viral DNA in PBMCs is very low and stable along the time. The aim of the ANRS EP36 study group is to precize the immunological and virological characteristics of these patients. First data seem to confirm an essential role of CD8 T cells to control viral replication, the absence of defective virus, and a normal susceptibility of the CD4 T cells from these patients to the infection with various HIV strains. This group of patients is homogeneous and its study supports physiopathological studies. To go further, a national survey of these patients has been set up to allow future study.