An 18-year-old French woman is in remission from HIV despite not having taken any drugs against the virus for 12 years.
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The girl’s mother did not have her HIV under control while pregnant, and the girl was infected either before or during birth.
She was initially treated with a drug created to prevent the infection from taking hold.
Starting antiretroviral treatment early against HIV is highly effective at preventing sexual transmission of the deadly virus in partners, a new study conducted in nine countries, including India, has found.
Researchers believe that something unique in the girl’s biology along with early treatment may have allowed her to control the infection albeit the exact reason now remains a mystery.
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Dr Asier Saez-Cirion, from the Institute Pasteur, in Paris, notes: “It’s likely that this girl has been in virological remission for so long because she received a combination of anti-retrovirals very soon after infection”.
In 2011, the HPTN 052 study investigators reported a breakthrough: Starting HIV treatment early, when the immune system is relatively healthy, reduced the risk of sexually transmitting the virus to an uninfected partner by 96 percent over 18 months.
“At the end of the day, we were just extremely privileged to have medicine, especially in the early 90s”, he says.
It was the first reported case of long-term remission for an HIV-infected child who dropped out of treatment.
Dr. Troy Grennan, physician lead of the B.C. Centre for Disease Control’s (BCCDC) Sexually Transmitted Infections/HIV program, said there’s no way of knowing how many people are taking the drug, but he doubts it is leading to more unsafe behaviours.
“I’m sure there will be others in the future”, he said, noting there are still relatively few studies of children infected at birth who are now young adults and have been monitored for their entire lives.
Astonished, the medical community is trying is asking what natural resistance to HIV could the teen have developed to experience a more than a decade remission without the use of often longlife treatments.
“This study conclusively shows that the benefits of early therapy far outweigh any adverse outcomes, and reinforces recommendations to offer immediate antiretroviral therapy to all patients”, said Anthony S. Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases (NIAID), one of the supporters of the study. Providing treatment for everyone living with HIV will be a paradigm shift in HIV treatment and prevention efforts, particularly for children living with HIV, and will save millions of lives.
More than 6,000 global experts are attending the Vancouver conference, and Montaner said they all need to have the same message when it comes to pressuring governments to support HIV treatment. This evidence should raise ambitions for the global HIV response to a level that will fully leverage the opportunities afforded by the latest scientific data.
The girl’s parents had stopped treatment for a year and then got her to the clinic where doctors were not able to detect any viral load and hence decided to stop treatment. They brought her back a year later, and doctors were surprised to find undetectable levels of HIV in her blood.
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“It seems like something is different” between post-treatment and elite controllers, says virologist Steven Deeks of the University of California, San Francisco.
