Nine-year-old Born With HIV Maintains Remission for 8 1/2 Years

A South African nine-year-old, who started HIV treatment soon after birth has remained free of the virus for the past 8 1/2 years. This leaves researchers hopeful about what the future of HIV treatments might possibly hold.

The case findings which were presented by scientists at the 9th IAS Conference on HIV Science in Paris on Monday, happen to be the world’s third reported case of sustained HIV remission in a child after early limited anti-HIV treatment. The first was a French child born with HIV in 1996, who started anti-HIV therapy at three months old and then stopped between ages five and seven. This child then remained in remission for over 11 years later. The second was a baby born in 2010, who started to receive treatment less than two days after birth but stopped after 18 months. This child only stayed in remission for 27 months.

The South African nine-year-old was diagnosed with HIV in 2007 just 32 days after birth, and soon after placed on antiretroviral treatment (ART) for 40 weeks. The infant was a part of a clinical trial called Children with HIV Early Antiretroviral (CHER), where HIV-infected infants were assigned at random to receive either deferred antiretroviral therapy or early, limited ART for 40 or 96 weeks.

“To our knowledge, this is the first reported case of sustained control of HIV in a child enrolled in a randomized trial of ART interruption following treatment early in infancy,” Dr. Avy Violari, head of pediatric clinical trials at the Perinatal HIV Research Unit at the University of Witwatersrand in South Africa,  and co-leader of the study said.

Prior to ART treatment, the child had extremely high levels of viral load– HIV in the blood– but after beginning the treatment at around nine weeks of age, the virus was undetectable. Researchers then continued to closely monitor the infant’s health years after treatment and found that the child remained in good health.

“We believe there may have been other factors in addition to early ART that contributed to HIV remission in this child,” Dr. Caroline Tiemessen, head of cell biology at the Centre of HIV and STIs of the National Institute of Communicable Diseases (NICD) in Johannesburg, said. “By further studying the child, we may expand our understanding of how the immune system controls HIV replication.”

The CHER trial, which was funded by the National Institute of Allergy and Infectious Diseases (NIAID), ran from 2005-2011. The purpose of the trial was to examine whether mortality rates could be reduced, but also whether earlier treatment could allow them to be taken off treatment for certain periods while remaining healthy.

For the clinical trial, 125 infants were randomly assigned to receive deferred therapy and 252 for early therapy. The results say that after a median follow-up of 40 weeks, ART was initiated in 66 percent of infants in the therapy group. Compared to the deferred-therapy group, 20 infants (16 percent) died and only 10 ( four percent) died in the early-therapy groups. The report also states that for 32 infants (26 percent) of the deferred-therapy group and 16 infants (6 percent) of the early-therapy groups, the disease progressed to Centers for Disease Control and Prevention stage C or severe stage B.

The group concluded that early HIV diagnosis and early antiretroviral therapy reduced early infant mortality by 76 percent and HIV progression by 75 percent.

“Further study is needed to learn how to induce long-term HIV remission in infected babies,” Anthony S. Fauci, M.D., director of NIAID, part of the National Institutes of Health (NIH), said. “However, this new case strengthens our hope that by treating HIV-infected children for a brief period beginning in infancy, we may be able to spare them the burden of life-long therapy and the health consequences of long-term immune activation typically associated with HIV disease.”

For further research into this health matter, NIH is conducting an ongoing trial called IMPAACT P1115, which is testing the hypothesis that giving ART to HIV-infected newborns beginning within 48 hours of birth may allow long-term control once treatment stops, NIAID says.

Feature Image via Flickr/ NIAID

 

About News Team

Hi, I'm Alex Perez, an experienced writer with a focus on lifestyle and culture news. From food and fashion to travel and entertainment, I love exploring the latest trends and sharing my insights with readers. I also have a strong interest in world news and business, and enjoy covering breaking stories and events.

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