Approaching the asymptote

The report in 2009 of an individual who had achieved long-term remission of HIV by transplantation of hematopoietic stem cells from a donor homozygous for a deletion in CCR5 (ccr5Δ32/ccr5Δ32 galvanised research around the world aimed at curing HIV. 1 Hütter G Nowak D Mossner M et al. Long-term control of HIV by CCR5 Delta32/Delta32 stem-cell transplantation. N Engl J Med. 2009; 360: 692-698 Crossref PubMed Scopus (1342) Google Scholar As the challenges to developing safe, effective, and scalable interventions to eradicate HIV mounted, many groups engaged in parallel efforts to control rather than to eliminate the viral reservoir. Various reports of people with sustained remission of HIV provide different models for long-term control of viral replication in the absence of antiretroviral therapy (ART), including so-called elite controllers, 2 Pereyra F Jia X McLaren PJ et al. The major genetic determinants of HIV-1 control affect HLA class I peptide presentation. Science. 2010; 330: 1551-1557 Crossref PubMed Scopus (887) Google Scholar post-treatment controllers, 3 Sáez-Cirión A Bacchus C Hocqueloux L et al. Post-treatment HIV-1 controllers with a long-term virological remission after the interruption of early initiated antiretroviral therapy ANRS VISCONTI Study. PLoS Pathog. 2013; 9e1003211 Crossref PubMed Scopus (729) Google Scholar , 4 Fajnzylber J Sharaf R Hutchinson JN et al. Frequency of post treatment control varies by antiretroviral therapy restart and viral load criteria. AIDS. 2021; 35: 2225-2227 Crossref PubMed Scopus (5) Google Scholar and children with perinatally acquired HIV who initiated ART early in infancy. 5 Frange P Faye A Avettand-Fenoël V et al. HIV-1 virological remission lasting more than 12 years after interruption of early antiretroviral therapy in a perinatally infected teenager enrolled in the French ANRS EPF-CO10 paediatric cohort: a case report. Lancet HIV. 2016; 3: e49-e54 Summary Full Text Full Text PDF PubMed Google Scholar Identifying the mechanisms underlying such control could suggest approaches by which similar states of sustained HIV remission might be induced through appropriate therapeutic interventions. Immunological and virological findings in a patient with exceptional post-treatment control: a case reportWe described long-term remission in a woman aged 59 years who was treated during primary HIV infection and has maintained undetectable viral load for 15 years without ART. Replication-competent HIV-1 was isolated. NKG2C-memory-like NK cells and γδ T cells were associated with the control viral replication. Strategies promoting these cells could bring about long-term HIV remission. Full-Text PDF