Skip to main content

Post-treatment Controllers

  • Living reference work entry
  • First Online:
Encyclopedia of AIDS

Definition

Post-treatment controllers (PTC) are HIV-infected patients able to maintain a durable control of viremia at undetectable levels after interruption of antiretroviral treatment. Differently from natural HIV “elite” controllers (HIC), post-treatment controllers require therapeutic intervention to first reach undetectable viral loads. Post-treatment controllers still carry infected cells and, thus, are not cured but considered to be in sustained remission of HIV infection. These patients have also been termed “secondary controllers.”

Introduction

The introduction of combination antiretroviral treatment (cART) as the standard of care for HIV-infected individuals changed the face of the AIDS epidemics. cART has drastically reduced mortality and morbidities of HIV-infected patients (Boyd 2009) and has also proven its value as a prevention tool by decreasing the risk of transmission (Cohen et al. 2011). A few years after cART was implemented, it was hypothesized that the perfectly...

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • Ananworanich J, Vandergeeten C, Chomchey N, et al. Early ART intervention restricts the seeding of the HIV reservoir in long-lived central memory CD4 T cells. In: 20th conference on retroviruses and opportunistic infections, Atlanta, 3–6 Mar 2013. Abstract 47.

    Google Scholar 

  • Ananworanich J, et al. Reduced markers of HIV persistence and restricted HIV-specific immune responses after early antiretroviral therapy in children. AIDS. 2014;28(7):1015–20.

    Article  CAS  PubMed  Google Scholar 

  • Boufassa F, et al. Blunted response to combination antiretroviral therapy in HIV elite controllers: an international HIV controller collaboration. PLoS One. 2014;9(1):e85516.

    Article  PubMed Central  PubMed  Google Scholar 

  • Boyd MA. Improvements in antiretroviral therapy outcomes over calendar time. Curr Opin HIV AIDS. 2009;4(3):194–9.

    Article  PubMed  Google Scholar 

  • Buzon MJ, et al. Long-term antiretroviral treatment initiated at primary HIV-1 infection affects the size, composition, and decay kinetics of the reservoir of HIV-1-infected CD4 T cells. J Virol. 2014;88(17):10056–65.

    Article  CAS  PubMed  Google Scholar 

  • Cohen MS, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Eisele E, Siliciano RF. Redefining the viral reservoirs that prevent HIV-1 eradication. Immunity. 2012;37(3):377–88.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Fiebig EW, et al. Dynamics of HIV viremia and antibody seroconversion in plasma donors: implications for diagnosis and staging of primary HIV infection. AIDS. 2003;17(13):1871–9.

    Article  PubMed  Google Scholar 

  • Goujard C, et al. HIV-1 control after transient antiretroviral treatment initiated in primary infection: role of patient characteristics and effect of therapy. Antivir Ther. 2012;17(6):1001–9.

    Article  CAS  PubMed  Google Scholar 

  • Hocqueloux L, et al. Long-term immunovirologic control following antiretroviral therapy interruption in patients treated at the time of primary HIV-1 infection. AIDS. 2010;24(10):1598–601.

    Article  PubMed  Google Scholar 

  • Hocqueloux L, et al. Long-term antiretroviral therapy initiated during primary HIV-1 infection is key to achieving both low HIV reservoirs and normal T cell counts. J Antimicrob Chemother. 2013;68(5):1169–78.

    Article  CAS  PubMed  Google Scholar 

  • Hutter G, et al. Long-term control of HIV by CCR5 Delta32/Delta32 stem-cell transplantation. N Engl J Med. 2009;360(7):692–8.

    Article  PubMed  Google Scholar 

  • Lodi S, et al. Immunovirologic control 24 months after interruption of antiretroviral therapy initiated close to HIV seroconversion. Arch Intern Med. 2012;172(16):1252–5.

    Article  PubMed  Google Scholar 

  • Luzuriaga K, et al. HIV type 1 (HIV-1) proviral reservoirs decay continuously under sustained virologic control in HIV-1-infected children who received early treatment. J Infect Dis. 2014. doi:10.1093/infdis/jiu297.

    Google Scholar 

  • O’Brien M, Markowitz M. Should we treat acute HIV infection? Curr HIV/AIDS Rep. 2012;9(2):101–10.

    Article  PubMed Central  PubMed  Google Scholar 

  • Paton NI. Treatment interruption strategies: how great are the risks? Curr Opin Infect Dis. 2008;21(1):25–30.

    Article  PubMed  Google Scholar 

  • Persaud D, et al. Absence of detectable HIV-1 viremia after treatment cessation in an infant. N Engl J Med. 2013;369(19):1828–35.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Piketty C, et al. A high HIV DNA level in PBMCs at antiretroviral treatment interruption predicts a shorter time to treatment resumption, independently of the CD4 nadir. J Med Virol. 2010;82(11):1819–28.

    Article  PubMed  Google Scholar 

  • Rosenberg ES, et al. Immune control of HIV-1 after early treatment of acute infection. Nature. 2000;407(6803):523–6.

    Article  CAS  PubMed  Google Scholar 

  • Saez-Cirion A, Pancino G. HIV controllers: a genetically determined or inducible phenotype? Immunol Rev. 2013;254(1):281–94.

    Article  PubMed  Google Scholar 

  • Saez-Cirion A, 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;9(3):e1003211.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Salgado M, et al. Prolonged control of replication-competent dual- tropic human immunodeficiency virus-1 following cessation of highly active antiretroviral therapy. Retrovirology. 2011;8:97.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Steingrover R, et al. HIV-1 viral rebound dynamics after a single treatment interruption depends on time of initiation of highly active antiretroviral therapy. AIDS. 2008;22(13):1583–8.

    Article  CAS  PubMed  Google Scholar 

  • Van Gulck E, et al. Immune and viral correlates of “secondary viral control” after treatment interruption in chronically HIV-1 infected patients. PLoS One. 2012;7(5):e37792.

    Article  PubMed Central  PubMed  Google Scholar 

  • Whitney JB, et al. Rapid seeding of the viral reservoir prior to SIV viraemia in rhesus monkeys. Nature. 2014;512(7512):74–7.

    CAS  PubMed  Google Scholar 

  • Yukl SA, et al. Challenges in detecting HIV persistence during potentially curative interventions: a study of the Berlin patient. PLoS Pathog. 2013;9(5):e1003347.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Asier Sáez-Cirión .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this entry

Cite this entry

Sáez-Cirión, A., Hocqueloux, L., Rouzioux, C. (2014). Post-treatment Controllers. In: Hope, T., Stevenson, M., Richman, D. (eds) Encyclopedia of AIDS. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9610-6_201-1

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-9610-6_201-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, New York, NY

  • Online ISBN: 978-1-4614-9610-6

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics