title: Reevaluation of possible outcomes of infections with human immunodeficiency virus.
abstract: Several lines of evidence indicate that HIV infection can result in several possible incomes, including a very small proportion of individuals whose HIV replication is controlled after treatment interruption (known as HIV posttreatment controllers) or spontaneously without any treatment (known as HIV elite controllers). Both types of individuals are HIV RNA negative but HIV DNA positive, with living virus which can be stimulated ex vivo. A review was conducted to assess the literature on yet rarer cases with detectable integrated HIV DNA without HIV infectious virus in HIV-seropositive or -negative individuals. Three categories of patients were identified: (a) HIV-seropositive individuals with apparent spontaneous cure from their HIV infection, (b) HIV-seronegative children born to HIV-infected mothers and (c) highly exposed seronegative adults. Validity criteria were proposed to assess the presence of integrated HIV DNA as possible or unquestionable in these three categories. Only three articles among the 22 ultimately selected fulfilled these criteria. Among the highly exposed seronegative subjects, some individuals were described as being without integrated HIV DNA, probably because these subjects were not investigated using relevant, highly sensitive methods. Finally, we propose a definition of spontaneous cure of HIV infection based on clinical, immunologic and virologic criteria.
authors.affiliation: IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Aix-Marseille University, URMITE UM 63 CNRS 7278 IRD 198 INSERM U1095, France.
authors.forename: C
authors.initials: C
authors.lastname: Tamalet
authors.affiliation: IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Aix-Marseille University, URMITE UM 63 CNRS 7278 IRD 198 INSERM U1095, France.
authors.forename: P
authors.initials: P
authors.lastname: Colson
authors.affiliation: Aix-Marseille University, CNRS AFMB Laboratory, UMR 7257, Case 925, France.
authors.forename: E
authors.initials: E
authors.lastname: Decroly
authors.affiliation: IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Service des Maladies Infectieuses, Hôpital Conception, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Dhiver
authors.affiliation: IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Service des Maladies Infectieuses, Hôpital Conception, Marseille, France.
authors.forename: I
authors.initials: I
authors.lastname: Ravaux
authors.affiliation: IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Service des Maladies Infectieuses, Hôpital Conception, Marseille, France.
authors.forename: A
authors.initials: A
authors.lastname: Stein
authors.affiliation: IHU Méditerranée Infection, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, France; Aix-Marseille University, URMITE UM 63 CNRS 7278 IRD 198 INSERM U1095, France. Electronic address: didier.raoult@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Raoult
mesh_terms: D004279:DNA, Viral / Q000097:blood*; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000276:immunology* / Q000821:virology*; D020276:HIV Long-Term Survivors; D006801:Humans
chemical_list: D004279:DNA, Viral; D015483:HIV Antibodies
keywords: Cure; HIV; dead-end infection; endogenous retrovirus; viral integration