S African girl, 9, is third child with HIV re­mis­sion

Kuwait Times - - HEALTH & SCIENCE -

A South African girl has be­come only the third child to beat the AIDS virus into long-term re­mis­sion-al­most nine years and count­ing-af­ter re­ceiv­ing a drug cock­tail in in­fancy, re­searchers an­nounced yes­ter­day. The child was given a ten-month course of anti-AIDS medicine un­til she was one year old, then taken off the drugs as part of a med­i­cal trial. Eight years and nine months later, the virus is still dor­mant and the girl healthy with­out need­ing treat­ment, a re­search team re­ported at the In­ter­na­tional AIDS So­ci­ety con­fer­ence on HIV sci­ence in Paris.

“This new case strength­ens our hope that by treat­ing HIV-in­fected chil­dren for a brief pe­riod be­gin­ning in in­fancy, we may be able to spare them the bur­den of life-long ther­apy,” said AIDS ex­pert An­thony Fauci, direc­tor of the Na­tional In­sti­tute of Al­lergy and In­fec­tious Dis­eases (NIAID) which funded the study. Some sci­en­tists re­fer to sus­tained, drug-free re­mis­sion as a “func­tional cure”. Un­like a tra­di­tional cure, where the virus is erad­i­cated, the pa­tient still has HIV in their sys­tem but it is so weak­ened that it can­not repli­cate or spread to sex­ual part­ners.

Re­searchers hope that by treat­ing peo­ple as soon as pos­si­ble af­ter in­fec­tion, they can one day in­duce drug-free re­mis­sion for sus­tained pe­ri­ods of time, per­haps for good. This has be­come a ma­jor fo­cus of re­search amid fad­ing hopes of find­ing a per­ma­nent cure. The virus has proven more sneaky than imag­ined-it has the abil­ity to hide out in hu­man cells and play dead for years, only to re-emerge and at­tack as soon as treat­ment is stopped. Anti-retro­vi­ral (ARV) treat­ment in­hibits the virus, but doesn’t kill it, and in­fected peo­ple have to take pills daily for life which are costly and have side-ef­fects.

Re­lapse pos­si­ble

A rare group of in­fected peo­ple-fewer than one per­cent-are able nat­u­rally to stop the virus repli­cat­ing. They are known as “elite con­trollers”, but the mech­a­nism by which they keep the virus at bay re­mains a mys­tery. The girl does not have “elite con­troller” DNA, said the study au­thors. Among peo­ple tak­ing virus-sup­press­ing anti-retro­vi­ral drugs, only a few have at­tained drug-free re­mis­sion. They in­clude 14 adults in a French trial who were able to quit their med­i­ca­tion af­ter three years and stayed healthy.

A French woman aged 20, treated as a baby, has been healthy for 14 years since stop­ping her med­i­ca­tion-the longest­known re­mis­sion. In the United States, the so-called Mis­sis­sippi Baby was in re­mis­sion for 27 months af­ter be­ing given ART for the first 18 months of life, but the virus re­bounded in a ma­jor let-down for re­searchers. Now there is the South African girl-the first case of re­mis­sion in a child en­rolled in a trial to test the ef­fec­tive­ness of early treat­ment, for a lim­ited time.

“Re­lapse is a pos­si­bil­ity in any case of re­mis­sion,” un­der­lined study co-leader Avy Vi­o­lari of the Uni­ver­sity of the Wit­wa­ter­srand in Jo­han­nes­burg. How­ever, “the fact that re­mis­sion has been for a long pe­riod sug­gests this is likely to be durable,” she said. Re­searchers do not un­der­stand how the girl achieved re­mis­sion when 410 other chil­dren in the trial did not. “We can’t tell if her im­mune sys­tem would have con­trolled the virus on its own or if the treat­ment made a dif­fer­ence,” said Sharon Lewin, a pro­fes­sor of medicine at the Uni­ver­sity of Mel­bourne. —AFP

PARIS: Con­fer­ence at­ten­dees sit dur­ing the open­ing of the 9th In­ter­na­tional AIDS So­ci­ety con­fer­ence on HIV Sci­ence in Paris.—AFP

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