What can spontaneous controllers, posttreatment controllers and postintervention controllers teach us about an HIV cure?

PURPOSE OF REVIEW: HIV controllers are a heterogenous population of people living with HIV who control viral replication without antiretroviral therapy. The purpose of this review is to summarize potential mechanisms of control and to highlight how these can be used in HIV cure strategies.

RECENT FINDINGS: Several recent studies have identified potent HIV-specific CD8 + T cell responses in posttreatment controllers who controlled viral replication after the discontinuation of antiretroviral therapy and postintervention controllers who achieved control after receiving broadly neutralizing antibodies alone or in conjunction with other immune modulators before antiretroviral therapy was discontinued. Other studies have implicated autologous neutralizing antibodies as a correlate of protection in both groups of controllers.

SUMMARY: The early initiation of antiretroviral therapy coupled with strategies to enhance HIV-specific CD8 + T cell and autologous neutralizing antibodies may lead to a higher incidence of posttreatment control.