[HIV controllers: how these patients control viral replication?].

Some patients infected by the HIV are called HIV controllers because viral replication remains undectectable during a prolonged period of time in the absence of any antiretroviral treatment. This state could be considered as a « functional cure » in these virally infected patients. Understanding mechanisms underlying this prolonged control of viral replication is key to the development of future vaccinal strategies. French ANRS is exploiting a cohort of HIV controllers since several years, and immunological analysis of these patients has yielded some mechanistic clues that this review will discuss. A striking feature is the very efficient and polyfunctional CD8 T cell response of these patients, which exhibits a high avidity against the gag protein of the virus. Other parameters and questions are studied : the role of HLA B57, overrepresented in this cohort ; how HIV controllers who do not express a very robust CD8 response control the viral replication ? The long term follow up of these patients will also give important informations on their -immunological, viral and clinical evolution.