Immunological features and clinical management of HIV controllers: The path to HIV remission

When someone gets HIV, they usually need to take daily medication for life. But there's a rare group of people, called HIV controllers, who can naturally keep the virus under control without any medication. Scientists are still trying to understand how this is possible. This thesis explored three main questions:
1. What’s special about the immune system of HIV controllers?
2. Can we predict if or when their control over the virus might stop working?
3. Should they still take HIV medication like everyone else?
We found that HIV controllers have a stronger innate immune system—that’s the part of your immune system you’re born with. Importantly, their family members also had stronger innate immunity. Their immune systems seemed to be “trained” by other infections before HIV, which may have helped them fight HIV more effectively later on.
We also looked at thousands of proteins in their blood. We discovered certain ones that could help us predict when someone might lose control over the virus. This could help doctors monitor HIV controllers more closely and act early if needed.
Lastly, we studied how long HIV controllers live—with and without taking HIV medication. As long as their virus levels stayed low, they lived just as long without medication. In fact, they often had fewer cardiovascular disease than other people with HIV who are not HIV controllers.
These findings could help researchers working on a cure for HIV. It also helps doctors give better, more personalized advice to HIV controllers about when to start HIV medication.