Grabar and colleagues set out to estimate the prevalence and characteristics of long-term nonprogressor and HIV controller patients in a very large French cohort of HIV 1-infected patients. In the French Hospital Database on HIV [FHDH, Agence Nationale de Recherches sur le SIDA et les hépatites virales (ANRS) CO4], they selected patients who had been seen in 2005, who had been infected for more than 8 years, who were treatment-naive, and who remained asymptomatic. Patients with these characteristics then categorized as follows: long-term nonprogressor (> or =8 years of HIV infection and CD4 cell nadir > or =500/microl), elite long-term nonprogressor (> or =8 years of HIV infection, CD4 cell nadir > or =600/microl, and a positive CD4 slope), HIV controllers (>10 years of HIV infection with 90% of plasma viral load values < or ="500" style="text-decoration: underline;">elite controllers (same as HIV controllers, but with last plasma viral load value < or ="50" style="text-decoration: underline;">46 880 HIV-1-infected patients followed in 2005 in the French Hospital Database on HIV, 0.4% (N = 202) were long-term nonprogressor, 0.05% (N = 25) were elite long-term nonprogressor, 0.22% (N = 101) were HIV controllers, and 0.15% (N = 69) were elite controllers. Ten elite long-term nonprogressor patients (40% of 25) were also HIV controllers, eight (32%) were elite controllers, and 60% had detectable plasma viral load (>50 copies/ml). Among the elite controllers, 32 (46%) were long-term nonprogressor, eight (12%) were elite long-term nonprogressor, and one-quarter had a last CD4 cell count less than 500/microl. Long-term nonprogressor, elite LTNP, HIV controller, and elite controller patients are rare phenotypes. Elite long-term nonprogressor patients are less frequent than HIV controllers. There is little overlap among the four subgroups of patients.
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