elite controller

elite controller (EC) – an HIV positive person whose immune system keeps viral load undetectable for more than five years without ART.

Elite controllers also have a very good CD4 count (always above 500 cells/mm3) that stays at a similar level over many years.

Even with this good immune response, ART is still generally recommended in the long-term. This is because over decades – some ECs have been undetectable for more than 20 years – there is a concern that low level HIV in different body compartments like the brain, might lead to accumulative serious damage that isn’t easy to detect until it is too late.

This is a real concern, though evidence is limited because of the rarity of ECs.

See: long-term slow progresso (LTSP)/long-term non-progessor (LTNP).