The dramatic effectiveness of antiretroviral therapy means that a diagnosis of HIV is no longer the death sentence it often was in the 1980s. Still, most infected individuals must take numerous medications that have many potential adverse effects for the rest of their lives and remain vigilant in monitoring their condition.
But for a minority of persons—about 1 in 300—antiretroviral medications aren't necessary. Some of these individuals have been infected with HIV for more than 30 years without developing progressive disease, and they have maintained low to undetectable levels of the virus in their blood without ever having taken antiretroviral drugs. While an untreated patient with HIV may have a viral load of more than a million HIV particles per milliliter of blood at the time of acute infection, elite controllers maintain an HIV viral load below 50 virus particles per milliliter of blood. Another group of untreated persons called viremic controllers maintain a viral load level ranging between 50 and 2000 particles.
Hampton T. “Elite Controllers” Provide Clues to Keeping HIV Infection in Check. JAMA. 2012;308(4):328–329. doi:10.1001/jama.2012.8463
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