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Review recently published research in the following three areas: long term nonprogression/viral control; determinants of viral load set point/disease progression; and potential Antiretroviral Therapy (ART) effects in early HIV infection.
With some HIV positive people being able to maintain high CD4 cell counts and/or suppressed viral loads in the absence of ART, the natural course of untreated HIV infection varies greatly. Although similar, the underlying mechanistic mechanisms that result in viral control and long term nonprogression are probably different. The identification of host factors that are causally connected to these traits through concerted ongoing research efforts should present prospects for the creation of novel therapeutic or preventive approaches. Although there is growing evidence that starting ART during primary infection may stop the immunological decline that would otherwise be seen in HIV infection left untreated, current studies have not focused on the longer term therapeutic advantages of starting ART at this very early stage.
It may be possible to find new targets for treatment and prevention of HIV infection by having a better understanding of the relative effects of viral, host, and environmental variables on the natural course of HIV infection.
