T cell dynamics and the response to HAART in a cohort of HIV1-infected elite suppressors. Clin Infect Dis 49

Elite controllers or suppressors are untreated human im-munodeficiency virus type 1 (HIV-1)–infected patients who maintain undetectable viral loads. In this study, we show that most elite suppressors do not experience significant changes in T cell counts over a 10-year period. Interestingly, treatment of an elite suppressor with highly active antiret-roviral therapy (HAART) led to a marked decrease in im-mune activation. Although CD4+ T cell depletion is the hallmark of progressive human immunodeficiency virus type 1 (HIV-1) infection, the mechanisms involved in this depletion are still not fully un-derstood. Some studies have shown that the HIV-1 load cor-relates with the rate of decay of CD4+ T cells [1, 2], whereas others have shown a strong correlation between level of im-mune activation and the degree of CD4+ T cell depletion [3