A non-progressor is someone who has been infected with the Human Immunodeficiency Virus (HIV) for seven to 12 years without developing full-blown AIDS. Researchers estimate that around one in 100 HIV patients is a non-progressor, and an even smaller number of people are “elite controllers” capable of suppressing their viral loads for extended periods of time. A great deal of research has been conducted on long-term non-progressors and elite controllers, with the goal of understanding why the disease does not progress in these individuals, and if non-progressors could hold a key to a treatment or cure for HIV/AIDS.
In order to be considered a non-progressor, someone must have stable CD4 counts within a normal range, and he or she must have no HIV/AIDS-related infections. Non-progressors have also never been treated with antiretroviral therapy in an attempt to suppress the disease. Some researchers consider a patient to be a non-progressor after seven years, while others prefer to wait 12 years before classifying someone as a non-progressor.
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Although the progress of the disease appears to be slowed or even stopped in long-term non-progressors, they can still develop AIDS. AIDS can emerge 15 to 30 years after the onset of HIV infection in some cases. Because of this, non-progressors must receive regular medical treatment and CD4 counts to make sure that they are still in non-progressor status.
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A number of theories have been posited in an attempt to explain why some people become non-progressors. Originally, researchers thought that non-progressors were infected with less virulent forms of HIV, but this theory has since proved incorrect. Non-progressors appear to have lower levels of HIV in their lymph nodes, which may have something to do with it, and some researchers have suggested that perhaps non-progressors produce effective antibodies against the virus. While everyone infected with HIV/AIDS develops antibodies, the antibodies are usually ineffective, so if the antibody theory is correct, it may mean that a vaccine is possible. There may be a strong genetic component involved as well, although more extensive research on the genomes of long-term non-progressors would be needed to support this theory.
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Elite controllers are sort of like the gold stars of the long-term non-progressors. Some elite controllers have viral loads so low that they are almost undetectable, which means that their bodies are definitely fighting HIV in some way. Learning how elite controllers suppress the virus in their bodies could be a critical step in HIV/AIDS research.