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.