Treatment Considerations in an HIV Elite Controller

HIV elite controllers naturally suppress viral loads below limits of detection and evidence lack of evolution of infection for prolonged periods. The role of antiretroviral therapy (ART) in these individuals is controversial. Though recent data suggest that ART may decrease immune activation and prevent complications such as development of accelerated cardiovascular disease (CVD); treatment has not clearly demonstrated a benefit on clinical outcomes (e.g., HIV disease progression, CVD events, mortality). We describe a 49-year-old female HIV elite controller who presented with asymptomatic HIV infection for 26 years and review recent literature on the role of ART in this population.