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How ‘special’ individuals could hold the key to HIV cure

A South African child has controlled HIV without drugs for over eight years in a highly rare and special case.

(File Photo)

A nine-year-old South African child, who was diagnosed with HIV at one month old, has been controlling the virus without treatment for the past eight and a half years. This rare case report was announced on Monday at the 9th International AIDS Society Conference on HIV Science being held in Paris this week.

The child was given HIV treatment for 40 weeks after diagnosis but was taken off antiretrovirals (ARVs) as part of a study to see how long the virus would take to rebound and begin replicating again. Usually, once a patient stops ARVs, the virus rebounds in a matter of weeks and researchers said they are monitoring this child to find clues which will bring the world closer to developing a cure for HIV.

South African researcher, and co-lead author for the trial in which the child was discovered, Dr Avy Violari said there “is still a lot more work to be done to understand” exactly how this child has managed to control the virus without the help of drugs.

HIV remission

“But we don’t believe [40 weeks of early treatment with] ARVs alone lead to remission,” she said.

The child’s gender and home-town has not been released to protect his/her privacy.

The study, called the CHER trial, took place between 2005 and 2011 in Soweto and Cape Town to investigate the optimal time for HIV positive infants to start HIV treatment and whether treatment could be safely interrupted.

Although there have been rare reports of patients controlling the virus without treatment in other parts of the world, this is the first such case in Africa.

The ‘Mississippi Baby’, born in 2010 in the United States (US), was started on treatment within two days of birth, stopped therapy at 18 months of age, and controlled the virus for over two years before the virus rebounded in her blood.

There have also been reports of a French teenager who has controlled the virus without drug therapy for more than 11 years.

Complex mechanisms

“There is probably a complex set of mechanisms keeping the virus from rebounding and one of the exciting challenges we have is to try figure out what they are,” Dr Anthony Fauci, from the US’ National Institute of Health, told Health-e News.

“Is it an immune response that one or more, but not everybody, produces when they get exposed to the virus? Is it something specific about the virus? Is it that when you treat someone early on you eliminate most of the replication-competent virus and what’s left is virus that’s not particularly competent at replicating? Does it have to do with the size of the virus reservoir? Is it none of the above or all of the above?”

Violari said the child’s family is “delighted” that he/she has suppressed the virus and shows no signs of needing ARVs for the moment.

“People are looking at those special individuals called elite controllers or post-treatment controllers, like this child, and I believe that’s where the answer is going to come from – from those very special individuals.” – Health-e News

An edited version of this story was also published in IOL

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