Prevalence and comparative characteristics of long-term nonprogressors and HIV controller patients in the French Hospital Database on HIV.
Grabar, Sophie a,b,c; Selinger-Leneman, Hana a,d,e; Abgrall, Sophie a,d,f; Pialoux, Gilles g; Weiss, Laurence b,h; Costagliola, Dominique a,d,e
23(9):1163-1169, June 1, 2009.
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Objective: To estimate the prevalence and characteristics of long-term nonprogressor (LTNP) and HIV controller patients in a very large French cohort of HIV1-infected patients.
Methods: In the French Hospital Database on HIV [FHDH, Agence Nationale de Recherches sur le SIDA et les hepatites virales (ANRS) CO4], we selected patients who had been seen in 2005, who had been infected for more than 8 years, who were treatment-naive, and who remained asymptomatic. Patients with these characteristics then categorized as follows: LTNP (>=8 years of HIV infection and CD4 cell nadir >=500/[mu]l), elite LTNP (>=8 years of HIV infection, CD4 cell nadir >=600/[mu]l, and a positive CD4 slope), HIV controllers (>10 years of HIV infection with 90% of plasma viral load values <=500 copies/ml), and elite controllers (same as HIV controllers, but with last plasma viral load value <=50 copies/ml in 2005).
Results: Among the 46 880 HIV1-infected patients followed in 2005 in the French Hospital Database on HIV, 0.4% (N = 202) were LTNP, 0.05% (N = 25) were elite LTNP, 0.22% (N = 101) were HIV controllers, and 0.15% (N = 69) were elite controllers. Ten elite LTNP patients (40%) were also HIV controllers, eight (32%) were elite controllers, and 60% had detectable plasma viral load (>50 copies/ml). Among the elite controllers, 32 (46%) were LTNP, eight (12%) were elite LTNP, and one-quarter had a last CD4 cell count less than 500/[mu]l.
Conclusion: LTNP, elite LTNP, HIV controller, and elite controller patients are rare phenotypes. Elite LTNP patients are less frequent than HIV controllers. There is little overlap among the four subgroups of patients.
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