Longitudinal quantification of human immunodeficiency virus type 1 DNA andRNA in long-term nonprogressors

Twenty patients with human immunodeficiency virus type 1 (HIV-1) infection for >7 years, no HIV-1-related symptoms, no treatment, and CD4(+) cell coun ts >500/mu L were included in a prospective study in 1993. Four years later , 12 patients had progressed (SPs), while 8 had not (long-term nonprogresso rs [LTNPs]), At;inclusion, HIV-1 RNA, but not DNA, levels were higher in SP s. During follow-up, a consistent increase in HIV-1 RNA was seen in only 1 LTNP, In 2 LTNPs, plasma viremia was persistently undetectable or <110 copi es/mL, Infectious virus was isolated from only 1 LTNP and from 11 SPs, In 4 LTNPs, HIV-1 DNA levels decreased spontaneously with time. The restricted viral replication and the declining HIV-1 DNA levels suggest that the HIV-1 infection can be controlled efficiently in a few LTNPs, leading to a decre ase in the total virus burden with time.