An 18-year-old woman has become the first child and teenager in the world to experience “long term-remission” from HIV, boosting hopes her case will help the search for a cure.
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The girl is one of a small group who have achieved remission from the virus, at least for a time, after early treatment with antiretroviral treatment (ART) aimed at keeping the virus from building up lasting reservoirs of the virus, which can reignite the infection.
An estimated 3.2 million children age 15 and under were living with AIDS at the end of 2013, according to the World Health Organization. It is most commonly caught by having unprotected sex, sharing infected needles or is passed on from an HIV-positive mother to her child during pregnancy, childbirth or breastfeeding.
She was initially treated with antiretroviral drugs as a prophylactic to prevent infection, and then given a combination of four antiretroviral drugs when the virus was found to persist.
These patients are a very rare exception to the rule, doctors caution: the vast majority of patients with HIV who stop treatment experience a rebound in virus levels that, if left untreated, can harm their health. It is not known if the infant contracted the virus whilst in the womb or during her birth. But her case marks the longest a patient diagnosed with HIV as a child has been free of the disease after ending drug treatment.
Search: UNAIDS, 90/90/90, test and treat, HIV, Africa, 8th global AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention. Saez-Cirion said it’s not known why the family halted the girl’s treatment.
Prof Lewin added: “Important though this case is, I strongly believe that to advance our efforts towards finding a cure for HIV, we need large prospective studies that can nail down who might be able to safely stop anti-viral therapy and keep the virus under control”. Even with these tools, significant implementation gaps must be closed, including the targeted deployment of proven prevention methods to the populations that need them most, says Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.
Twelve years later, the virus levels in her bloodstream are too low to be measured – although doctors have cautioned that this could change.
Adherence counselling works best alongside viral load monitoring, the gold standard for ensuring that people’s treatment is working and that they are maintaining the desired “undetectable” level of HIV, which is best for their own health and also reduces the likelihood of HIV transmission to close to zero.
“Many kids have gone off treatment – and treated that early – and we haven’t seen this outcome”.
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Dr. Julio Montaner, director of the B.C. Centre for Excellence in HIV-AIDS, said science has clearly proven that giving people with HIV early access to treatment saves lives. But, he says of the French teenager and other post-treatment controllers, “it’s impossible to prove that they would not have done well in the absence of therapy”. Asier Sáez-Cirión, an assistant professor at the Pasteur Institute in Paris, was clear, however, saying, “The girl is in remission”. The study began in 2005 and discordant couples – when one partner is HIV-positive and the other HIV-negative – were recruited from nine countries.
