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A rare subset of HIV-infected individuals, designated viremic non-progressors (VNP), remain asymptomatic and maintain normal levels of CD4+ T-cells despite persistently high viremia. To identify mechanisms potentially responsible for the VNP phenotype, we compared VNPs (average >9 years of HIV infection) to HIV-infected individuals who have similar CD4+ T-cell counts and viral load, but who are likely to progress if left untreated (“putative progressors”, PP), thus avoiding the confounding effect of differences related to substantial CD4+ T cell depletion. We found that VNPs, compared to PPs, had preserved levels of CD4+ stem cell memory cells (T SCM  ( p <0.0001), which was associated with decreased HIV infection of these cells in VNPs (r = −0.649,  p  = 0.019). In addition, VNPs had decreased HIV infection in CD4+ central memory (T CM ) cells ( p  = 0.035), and the total number of T CM  cells was associated with increased proliferation of memory CD4+ T cells (r = 0.733,  p  = 0.01). Our results suggest that, in HIV-infected VNPs, decreased infection of CD4+ T CM  and T SCM , cells are involved in preservation of CD4+ T cell homeostasis and lack of disease progression despite high viremia.

Limited HIV Infection of Central Memory and Stem Cell Memory CD4+ T Cells Is Associated with Lack of Progression in Viremic Individuals