Mechanisms of HIV non-progression; robust and sustained CD4+ T-cell proliferative responses to p24 antigen correlate with control of viraemia and lack of disease progression after long-term transfusion-acquired HIV-1 infection

Dyer, Wayne B; Zaunders, John J; Yuan, Fang Fang; Wang, Bin; Learmont, Jennifer C; Geczy, Andrew F; Saksena, Nitin K; McPhee, Dale A; Gorry, Paul R; Sullivan, John S

From all reported TAHIV cases from the state of NSW, Australia, a cohort of 13 (10%) remained asymptomatic after 10 years of infection. We now report that only 5 remain non-progressors after 23 to 26 years of HIV-1 infection. Infection and treatment history for each subject is summarised in Additional file 1. Most of these individuals had a survival advantage, with 7 of 13 having at least one host genetic polymorphism associated with slow progression, and 6 of 13 were infected with the SBBC nefdefective HIV-1 strain [12] , and combined, 12 of 13 had at least one host or viral factor favouring slow progression. Acting in opposition to these survival advantages, 5 of 8 former non-progressors had the FcγRIIA polymorphism (R/R). While this genotype was absent in current LTNP, the effect of the R/R genotype in promoting disease progression was not significant in this small study of 13 individuals. On balance, these competing survival factors along with antiviral immune responses enabled a nonprogressive disease course to be established early in infection.