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.
Factors associated with HIV pathogenesis (higher baseline CD4+ cells count) as well as factors associated with care (ZDV use during the neonatal period, start of ART before patient reaches class C diagnosis condition or severe immunosuppression) were related to LTNP in the 9-year cohort study.
In this cohort, the introduction of ART before patients reached CDC categories C and/or 3 was associated with LTNP.
The use of ZDV during the neonatal period was associated with LTNP, even when adjusting for age at follow-up initiation.
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.
For example, one study observed that CD8 T cell responses specific for the HIV envelope protein were restricted by HLA-Cw7 in LTNPs (Viral Immunol, 11:3, p.