showed that the LTNP elite controllers appear to reconstitute T-cells more slowly than other patients, while McKinnon and colleagues found that only CD4 nadir, and not elite controller status, was associated with slower rates of immune reconstitution.
The case also emphasises how further classification of LTNP types may guide strategies in the future, particularly in the developing world where assays are generally not as sensitive.
The study of LTNPs has revealed much about the natural history of HIV infection.
Moreover, the epigenetics of subtype C in southern Africa may not be conducive to LTNPs.
The DHHS guidelines mention LTNPs with high viral loads and elite controllers with immune or clinical failure and state that: 'although therapy may be theoretically beneficial for patients in either group, clinical data supporting therapy for non-progressors and elite controllers are lacking.
LTNPs have one distinct advantage: they are able to suppress viral replication and maintain stable CD4 T cell levels over time in the absence of antiretroviral therapy.
Similarities have been observed between LTNPs and individuals who have recently seroconverted.
Indeed there is increasing consensus that for many LTNPs a combination of factors may be at work and that these additive effects may vary with the individual.
Research suggests that altered nef sequences may play a role in nonprogression for some LTNPs, but certainly not all.
Subsequent research has shown that some LTNPs are heterozygous for the CCR5 mutation, called "CCR5 delta 32," i.