Long-term survival

Some people with HIV progress slowly and survive longer. Less than 1% of people may not progress at all. In addition, some people with immune damage and low CD4 cell counts can remain well for long periods of time for unknown reasons.

Several studies have suggested that when a group of long-term non-progressors is observed over time, a growing proportion start to exhibit signs of disease progression.1 2 There is evidence, though, of non-progression in some individuals. These patients seem able to control HIV infection, possibly due to strong CD8 cytotoxic T-cell responses or genetic reasons.3

Some long-term non-progressors also seem to produce antibodies against their own CCR5 receptors, causing down regulation of the receptors that block HIV replication. Interestingly, in individuals who lose these antibodies, disease begins to progress again.4 

Deletion of parts of HIV’s genome have also been found to be responsible for long-term non-progression. This has occurred in isolated groups of individuals infected with unusual strains of HIV that has a deletion in part of the nef gene.5

Further studies are underway that are attempting to identify factors associated with long-term non-progression of HIV disease.

References

  1. Guerin J et al. Nonprogressors in the Australian long-term nonprogressor cohort: proportions and predictions. Second International AIDS Society Conference on HIV Pathogenesis and Treatment, Paris, abstract 454, 2003
  2. Vento S et al. Can we really identify HIV-1 long-term nonprogressors? J Acquir Immune Defic Syndr 37: 1218-1219, 2004
  3. Brostrom C et al. Longitudinal quantification of human immunodeficiency virus type 1 DNA and RNA in long-term nonprogressors. J Infect Dis 179: 1542-1548, 1999
  4. Pastori C et al. Long-lasting CCR5 internalization by antibodies in a subset of long-term non-progressors: a possible protective effect against disease progression. Blood 107: 4825-4833, 2006
  5. Kondo M et al. Identification of attenuated variants of HIV-1 circulating recombinant form 01-AE that are associated with slow disease progression due to gross genetic alterations in the nef/long terminal repeat sequences. J Infect Dis 192: 56-61, 2005
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.