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Trending Science: South African child born with HIV in long-term remission

A nine-year-old born with HIV in South Africa was treated for the first year and went on to live drug-free for eight and a half years – the virus has not returned. Early antiretroviral therapy was not standard practice at the time, but was given to the child from nine weeks old as part of a clinical trial.
Trending Science: South African child born with HIV in long-term remission
The child, whose identity is being protected, was treated for 40 weeks reports the BBC. Unlike other participants of the trial, levels of the virus became undetectable. This is now the third instance of early therapy, which attacks the virus before it has a chance to fully establish itself, being implicated in child ‘cure’ cases. Dr Avy Violari, the head of paediatric research at the Perinal HIV Research Unit in Johannesburg, said, ‘We don't really know why this child has achieved remission – we believe it's either genetic or immune system-related.’

The case was discussed at the 9th International AIDS Society conference on HIV Science on July 23, 2017, in Paris. However, the UK’s Independent newspaper reports the researchers as saying that the child does not have a gene mutation that gives natural resistance to HIV infection so remission is likely due to the early treatment. Whatever the cause, experts attending a Paris conference to discuss the trial were left surprised at the child’s condition. They stress the case is extremely rare, and does not suggest a simple path to a future cure for Aids.

A case that raises more questions than it answers

Linda-Gail Bekker, President of the International Aids Society said the study raises the ‘interesting notion that maybe treatment isn’t for life’ but was ‘clearly a rare phenomenon’. So far only two other children have experienced similar results. A child in France and one in America were both treated very early on and then came off medication; the latter then had to resume when the virus reappeared in her blood. She was able to control the condition after treatment resumed.

Researchers believe the South African case is the first instance of sustained virological control from a randomised trial of ART interruption following early treatment of infants. ‘At age 9.5 years, the child was clinically asymptomatic,’ the researchers said.

The current medication, antiretroviral drugs (ART) which can cause unpleasant side effects, are taken by 18 million people globally, about half of those living with the disease. The hope is that the drugs could be replaced with injections administered every six years that would continuously release medication into the blood stream.

Dr Michael Brady, medical director of the Terrence Higgins Trust, a charity which aims to end the transmission of HIV in the UK, told the Independent that the case report was ‘really interesting’. He explained early HIV therapy, in both children and adults, has been shown to reduce some of the damage to the immune system that HIV causes in the first few weeks and months of infection. ‘If we can understand this mechanism better it will hopefully lead to novel treatment strategies and, maybe one day, a cure.’

Source: Based on media reports

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  • France, United Kingdom, South Africa
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