Low Level of Regulatory T Cells and Maintenance of Balance Between Regulatory T Cells and TH17 Cells in HIV-1-Infected Elite Controllers

Background: A subgroup of HIV-1-infected individuals, elite controllers, have spontaneous viral control and offer an exceptional opportunity to study virological and immunolocigal factors of possible involvement in control of HIV-1 infection. Methods: The frequencies of Tregs and TH17 cells was evaluated and correlated to markers of disease progression in peripheral blood mononuclear cells from 3 different groups of individuals infected with HIV-1: treatment-naive viremic individuals, individuals on successful highly active antiretroviral therapy, and elite controllers. In addition, a group of HIV-1-negative individuals were included. Results: We demonstrate that elite controllers have lower levels of Tregs compared with HIV-1-infected viremic individuals, but that the low Treg level does not differ between individuals with HIV-1 control, whether natural or therapy induced. We also show that T-cell activation and proliferation both correlate to the level of Tregs. Finally, the TH17/Treg ratio was similar in Elite Controllers and uninfected controls, whereas in viremic and treated HIV-1-infected individuals, the TH17/Treg ratio was lower compared with uninfected controls. Conclusions: We show that one feature of spontaneous HIV-1 control is a maintained balance between regulatory T cells and TH17 cells.