Elite controllers and long-term nonprogressors: Models for HIV vaccine development?

Elite controllers and Long-term nonprogressors (LTNP) are uncommon subgroups of HIV-infected individuals that are typically associated with improved clinical outcomes compared to other members of the HIV-infected population. These groups have particularly desirable characteristics for developing a therapeutic vaccine for HIV infection, namely spontaneous virologic suppression in elite controllers and prolonged elevation in CD4 cell counts in LTNP. Despite these favorable characteristics, some individuals in these groups experience HIV disease progression including virologic escape, CD4 decline, and the development of AIDS and serious non-AIDS events. Due to the heterogeneity observed in these populations, it is essential to select individuals with durable virologic control and/or CD4 cell count trajectories when considering elite controllers and LTNP as models for development of therapeutic vaccines.