Of 312 such patients, only 50 had stable CD4 cell counts, with only 13 having CD4 cell counts consistently in the normal range. identified ART-naive asymptomatic individuals infected with HIV for more than 7 years. In contrast, only 0.4% of patients in the French Hospital's Database on HIV were identified as LTNP. reported a prevalence of 5.02% in a military cohort. Using a similar definition but with only 7 years of follow-up, Okulicz et al. identified asymptomatic individuals who remained off ART for more than 8 years with a CD4 cell count more than 500 cells/μl using this definition, 9% of their clinic population were identified as LTNP. Although it is widely reported that 1–5% of the HIV-positive population are LTNP, these estimates are complicated by the fact that there is no standardized definition of a LTNP, and thus definitions used (and the way in which they are applied, particularly in the presence of varying follow-up and irregularly measured CD4 cell counts) differ widely (Table (Table1) 1). Long-term nonprogressors (LTNP) are individuals who remain asymptomatic for a prolonged period of time off ART with a high CD4 cell count (see reviews by Poropatich and Sullivan and Gaardbo et al.).
It is hoped that the information obtained through the identification of such individuals might provide insight for the development of vaccines and novel treatment approaches. The past decade has seen considerable interest in the identification of subgroups of HIV-positive persons who exhibit distinct patterns of disease progression.
The natural course of untreated HIV infection varies widely. LONG-TERM NONPROGRESSORS AND ELITE CONTROLLERS
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