title: T cell Activation does not drive CD4 decline in longitudinally followed HIV-infected Elite Controllers.
abstract: BACKGROUND
  Elite controllers (EC) are a rare subset of HIV infected individuals who control viral load below 50 copies/ml of plasma without treatment.
  
  
  METHODS
  Thirty four EC were studied. The slope of CD4 count change was available for 25 of these subjects. We assessed immune activation by measuring the percent of CD38+HLA-DR+CD8+ T cells in the EC group and comparing it with that in 24 treatment-naïve HIV disease progressors and 13 HIV uninfected healthy controls.
  
  
  RESULTS
  Compared to HIV uninfected subjects, EC had higher percentages of CD38+HLA-DR+CD8+ T cells (p < 0.001) that was lower than that observed in progressors (p < 0.01). Fifteen of 25 EC had a slope of CD4 count change that was not significantly different from 0 while 3 had a positive and 7 a negative CD4 count slope. Immune activation did not distinguish EC subsets with stable/increasing versus declining CD4 counts.
  
  
  CONCLUSIONS
  Elevated immune activation in ECs is not associated with a faster rate of CD4 decline.
authors.affiliation: Research Institute of the McGill University Health Centre, Montréal, Québec, Canada. nicole.bernard@mcgill.ca.
authors.forename: Philomena
authors.initials: P
authors.lastname: Kamya
authors.forename: Christos M
authors.initials: CM
authors.lastname: Tsoukas
authors.forename: Salix
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authors.lastname: Boulet
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Routy
authors.forename: Réjean
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authors.lastname: Thomas
authors.forename: Pierre
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authors.lastname: Côté
authors.forename: Mohamed-Rachid
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authors.lastname: Boulassel
authors.forename: Bernard
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authors.lastname: Lessard
authors.forename: Rupert
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authors.lastname: Kaul
authors.forename: Mario
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authors.forename: Colin
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authors.forename: Cecile L
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authors.lastname: Tremblay
authors.forename: Nicole F
authors.initials: NF
authors.lastname: Bernard