A 38-year-old HIV elite controller from Bengaluru, Karnataka, India

Elite controllers (ECs) constitute a rare subset of HIV-infected individuals who possess the remarkable ability to suppress viral replication (defined as an undetectable viral load or viral load <50 copies/ml for >12 months) in the absence of antiretroviral therapy (ART). Studies show that immunological parameters and indicators of long-term complications demonstrate the benefits of initiation of ART even in patients with undetectable viral loads or normal CD4 levels. We describe one such HIV EC from Bengaluru, Karnataka, India. This HIV-positive patient has been asymptomatic for several years in the absence of treatment. Multiple tests on viral load were undetectable. The patient was initiated on ART in view of falling CD4 counts, to ameliorate the high CD8 levels and to prevent future cardiovascular events.