Healthy HIV-positive child represents breakthrough for research

A SOUTH African HIV-positive child has been without anti-retroviral treatment for almost nine years and is healthy‚ with only trace amounts of the virus in the body.

This was announced at the International Aids Society conference in Paris yesterday.

The child‚ whose gender has not been revealed‚ was part of a US National Institutes of Health-funded study.

The South African part of the trial was headed by Dr Avy Violari‚ head of paediatric research at the Perinatal HIV Research Unit at Wits University.

Violari said being part of the research was very exciting.

In 2008, the baby was diagnosed as HIVpositive at 32 days and put on anti-retroviral treatment nine weeks after birth.

Then the child was taken off treatment at 40 weeks, along with 125 babies in the international study on the early treatment of babies.

The child has not required medication since then.

Before treatment at nine weeks, the child had high levels of HIV in the blood.

Now the virus is not replicating and researchers can only find trace amounts of the virus in the immune system and a tiny immune response to HIV.

“To our knowledge‚ this is the first reported case of sustained control of HIV in a child enrolled in a randomised trial of antiretroviral treatment interruption following treatment early in infancy‚” Violari said.

A child known as “the Mississippi baby” started treatment 48 hours after birth and the mother stopped her treatment at 18 months. The child managed without treatment for 27 months.

Researchers hope that putting HIV-positive babies on treatment as soon as possible would mean some might be able to stop treatment for a time.

US National Institute of Allergy and Infectious Diseases director Anthony Fauci said: “Further study is needed to learn how to induce long-term HIV remission in infected babies.”

The institute is part of the US National Institutes of Health.

Fauci said there would be a spectrum of children who would be in remission for different periods.

“However‚ 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 and the health consequences of long-term immune activation typically associated with HIV disease.”

Fauci said it strengthened the argument that babies born positive must be put on treatment as soon as possible as it stopped the virus from entering too many cells.

Mother-to-child preventive treatment has reduced the rate of South African children born HIV-positive to fewer than 2% of all babies born to HIV-positive mothers.

“Infants in South Africa do get treatment earlier since birth testing has been introduced in the public sector. Therefore infant anti-retroviral treatment can be started within weeks of birth‚” Violari said.

“Remission is rare, but even if these children don’t achieve remission‚ starting ARVs earlier improves their health significantly.”

He said the unique child was being studied to teach scientists more about controlling HIV.

“By studying the immune response of these cases we can learn more about the immune system and what is important for viral control in addition to anti-retroviral therapy.”