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Clin Infect Dis. 2016 May 15;62(10):1304-1309. doi: 10.1093/cid/ciw120. Epub 2016 Mar 1.

Analysis of Non-AIDS-Defining Events in HIV Controllers.

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Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital.
Infectious Diseases Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona.
Centro Sanitario Sandoval, Instituto de Investigacion Sanitaria San Carlos (IdISSC).
Instituto de Investigacion Sanitaria-Fundacion Jimenez Díaz (IIS-FJD), Universidad Autonoma de Madrid (UAM).
Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid.
Hospital General de Elche and Universidad Miguel Hernández, Alicante.
AIDS Immunopathology Unit, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.



Human immunodeficiency virus (HIV) controllers have the striking ability to maintain viremia at extremely low or undetectable levels without antiretroviral treatment. Even though these patients have been widely studied, information about clinical outcomes, especially concerning to non-AIDS-defining events (nADEs), is scarce. We have analyzed the frequency and rate of nADEs and their associated factors in a large multicenter HIV controller cohort.


Data on nADEs were recorded for 320 HIV controllers within the multicenter Spanish AIDS Research Network HIV Controllers Cohort (ECRIS). Percentages and crude incidence rates (CIRs) per 100 person-years of follow-up (PYFU) were calculated for the entire follow-up period and for 2 separate periods: the period under control and the period after loss of control. These rates were compared with those for 632 noncontrollers. Demographic and immunological data collected from the controllers were included in a multivariate model to assess factors that were independently associated with nADEs in HIV controllers.


HIV controllers experience nADEs, albeit at lower rates than patients who do not spontaneously control the virus (1.252 [95% confidence interval {CI}, .974-1.586] per 100 PYFU and 2.481 [95% CI, 2.153-2.845] per 100 PYFU, respectively; P < .001). Hepatitis C virus (HCV) coinfection was the main factor associated with nADEs in all of the studied periods. Although hepatic events were the most prevalent, they represented only approximately 30% of the total events. CIRs of cardiovascular events increased in the post-loss-of-control period.


HCV/HIV coinfection was the main factor associated with hepatic and extrahepatic nADEs in HIV controllers. The eradication of HCV infection may ameliorate the presence of comorbidities in these patients.


HCV coinfection; HIV; controllers; non-AIDS-defining events

[Indexed for MEDLINE]

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