Toddler gives hope for HIV cure

2017-07-30 05:56
The world is closer to finding a cure after an HIV infected child treated early achieved remission. Picture: Supplied

The world is closer to finding a cure after an HIV infected child treated early achieved remission. Picture: Supplied

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Could a little South African girl be the answer to an Aids-free generation?

Although it’s too early to tell, scientists believe she has brought them closer to finding a cure to a disease that killed at least 1 million people worldwide just last year.

The nine-year-old, whose identity has been withheld to protect her and her family, made history recently when she proved to be the first child participating in an early antiretroviral (ARV) therapy trial to control HIV after stopping treatment.

The news of her ability to achieve remission after being infected with the virus at birth surfaced on Monday at the ninth International Aids Society Conference on HIV Science in Paris.

Avy Violari, head of paediatric research at the Perinatal HIV Research Unit in the Faculty of Health Sciences, University of the Witwatersrand, reported the case at the conference.

Violari co-led the Children with HIV Early Antiretroviral Therapy trials in which the symbolic case emerged, with Mark Cotton, head of the Division of Paediatric Infectious Diseases and director of the Family Infectious Diseases Clinical Research Unit at Stellenbosch University.

Violari said that, as far as the team knew, “this is the first reported case of sustained control of HIV in a child enrolled in a randomised trial of ARV treatment interruption following treatment early in infancy”.

The little girl was infected with HIV at birth.

She was diagnosed as HIV-positive in 2007, when she was a month old, and was then enrolled on the Children with HIV Early Antiretroviral Therapy clinical trial, funded by the National Institute of Allergy and Infectious Diseases, where she started receiving HIV treatment.

Before starting the treatment, the child had a high viral load, but, at about nine weeks old, the ARVs had suppressed the virus to undetectable levels.

Ten months after starting treatment, the treatment was stopped and her immunity was closely monitored.

Caroline Tiemessen, the senior author of this case and research professor in virology in the School of Pathology at Wits, who led the key laboratory investigations, said the child had remained in good health during years of follow-up examinations.

“We believe there may have been other factors in addition to early ARV treatment that contributed to HIV remission in this child.

"By further studying the child, we may expand our understanding of how the immune system controls HIV-1 replication,” said Tiemessen, who is also the National Research Foundation department of science and technology research chair in HIV vaccine translational research, and head of cell biology at the Centre for HIV and STIs of the National Institute of Communicable Diseases in Johannesburg.

However, this was not the first time that an HIV-infected child who was treated early on achieved remission.

In 2010, a baby in Mississippi received ARVs 30 hours after birth and stopped therapy at around 18 months of age. While the child managed to control the virus without drugs for 27 months, it then reappeared in her blood.

In 2015, researchers reported that another child – born with HIV in 1996 – who started anti-HIV therapy at the age of three months and stopped treatment sometime between the ages of five and seven, had continued to control the virus without drugs more than 11 years later.

Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said:

“All three cases strengthen our hope that, by treating children infected with HIV for a brief period beginning in infancy, we may be able to spare them the burden of lifelong therapy and the health consequences of long-term immune activation typically associated with HIV-1.”

However, he said that “further study is needed to learn how to induce long-term HIV remission in infected babies”.

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