Determinants of natural HIV-1 control


HIV-1 infection usually progresses to AIDS within 10 years in antiretroviral therapy untreated individuals, but there is a group of infected individuals who naturally control the infection. The mechanisms underlying natural HIV-1 control are not fully understood. Multiple factors are at play in different individuals; the achievement of control cannot be explained by one single factor. The purpose of this review is to give a concise overview of the different viral and host factors associated with differences in HIV-1 clinical outcome to date. While these factors are discussed separately, it is important to note that they are closely interlinked: the majority of host genetic factors linked to altered disease course mediate their effect through influencing host immune responses to HIV-1; similarly, most viral genetic factors associated with slower or faster rates of disease progression are themselves consequences of host immune responses and/or affect pathogenesis through altering the effectiveness of host immune responses.

SANTHE is an Africa Health Research Institute (AHRI) flagship programme funded by the Science for Africa Foundation through the DELTAS Africa programme; the Bill & Melinda Gates Foundation; Gilead Sciences Inc.; and the Ragon Institute of Mass General, MIT, and Harvard.