title: Early control of HIV-1 infection in long-term nonprogressors followed since diagnosis in the ANRS SEROCO/HEMOCO cohort.
abstract: BACKGROUND
  To clarify early correlates and natural history of HIV long-term nonprogressors (LTNPs) since HIV diagnosis.
  
  
  METHODS
  Patients enrolled in the French ANRS SEROCO/HEMOCO cohort with CD4 count >500 cells/mm3 at HIV diagnosis. LTNP status was defined as being asymptomatic, antiretroviral free, and with CD4 cell count >500 cells/mm3 for >8 years after HIV diagnosis. In LTNPs, we modeled the biological markers' progression through a joint model. Factors associated with loss of LTNP status were identified through a Cox model.
  
  
  RESULTS
  Sixty (9%) of 664 patients were identified as LTNPs during follow-up. At enrollment, HIV RNA was <or=2.6 log copies/mL in 24% of LTNPs and HIV DNA was <or=1.85 log copies/10 peripheral blood mononuclear cells (PBMCs) in 31% vs. 3% and 8% in others. In LTNPs, HIV RNA and HIV DNA levels increased by 0.04 log copies/mL per year and 0.07 log copies/10(6) PBMCs per year during the first 8 years after diagnosis. LTNP status was lost in 36 subjects; baseline HIV DNA >1.85 log copies/10(6) PBMCs and high HIV DNA increase were associated with an increased risk of losing LTNP status [adjusted hazard ratio: 2.8 (1.2-6.8) and 2.2 (1.0-4.8), respectively].
  
  
  CONCLUSIONS
  LTNP status is established in the first years of HIV infection, low HIV DNA level at enrollment and slow increase of HIV DNA being associated with maintained LTNP status.
authors.affiliation: INSERM U822, Le Kremlin-Bicêtre, France. yoann.madec@pasteur.fr
authors.forename: Yoann
authors.initials: Y
authors.lastname: Madec
authors.forename: Faroudy
authors.initials: F
authors.lastname: Boufassa
authors.forename: Veronique
authors.initials: V
authors.lastname: Avettand-Fenoel
authors.forename: Samia
authors.initials: S
authors.lastname: Hendou
authors.forename: Adeline
authors.initials: A
authors.lastname: Melard
authors.forename: Soraya
authors.initials: S
authors.lastname: Boucherit
authors.forename: Janina
authors.initials: J
authors.lastname: Surzyn
authors.forename: Laurence
authors.initials: L
authors.lastname: Meyer
authors.forename: Christine
authors.initials: C
authors.lastname: Rouzioux
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood; D018450:Disease Progression; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000097:blood; D013997:Time Factors; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D012367:RNA, Viral