SA child’s HIV ‘miracle’
A child’s miraculous HIV remission in SA has sparked speculation that a cure for the deadly disease is not far off
THE discovery was described as one of the most exciting developments in the war against a rampant virus once regarded as a death sentence. A South African child who was diagnosed with HIV 32 days after birth had beaten the virus into long-term remission – almost nine years after receiving a drug cocktail as part of a clinical trial as a baby.
This child is the third one with HIV to go into remission and has given scientists renewed hope of finding a cure for a virus that affects 36,7 million people – seven million of them in South Africa.
The child is regarded as “functionally cured”, meaning there are still traces of the virus in their system but it’s so weak it can’t replicate or spread to others.
Here’s a look at the remarkable case and what it could mean for those living with HIV.
NEW HOPE The breakthrough was on everyone’s lips at the recent International Aids Society (IAS) Conference on HIV Science in Paris, France. At the age of one month the child, whose identity is protected, was enrolled in a Children with HIV Early Antiretroviral Therapy (CHER) trial led by Dr Avy Violari and Dr Mark Cotton.
When the child was nine weeks old the treatment suppressed the virus to undetectable levels and medication was stopped as part of the trial process.
Doctors have maintained a close watch on the child’s immune system and the presence of the virus.
“This is the first reported case of sustained control of HIV in a child enrolled in a randomised trial following treatment early in infancy,” Violari says.
PROMISING POSSIBILITIES The key lab investigations were led by Professor Caroline Tiemessen of the National Institute for Communicable Diseases, who’s a virology researcher at the school of pathology at Wits University in Johannesburg.
“We believe there may have been other factors in addition to early antiretroviral therapy (ART) that contributed to HIV remission in this child,” she says. “By studying the child, we could expand our understanding of how the immune system controls replication of HIV-1 [the strain of the virus the child was born with].”
But just because this child showed a positive response to treatment doesn’t mean all kids will react in the same way.
“We think the genetics of the child and the child’s immune response are components that aided this outcome.”
OTHER “MIRACLES” The case of the SA child is the third reported instance of sustained HIV-1 remission in a child after early limited ART treatment. The first case, a baby in Mississippi in the USA born with HIV-1 in 2010, received ART 30 hours after birth, stopped treatment at 18 months and controlled the virus without drugs for 27 months before it reappeared in her blood.
The second case, reported in 2015, was a French child born with HIV-1 in 1996 who started ART three months after birth, stopped treatment sometime between five-and-a-half and seven years, and continues to control the virus.
THIS ISN’T A GENERAL CURE Professor Deenan Pillay, virology professor at the University of KwaZulu-Natal, says it’s important not to create the impression that children can stop taking the medication in light of what happened with the nine-year-old SA child.
“We have to remember that HIV infects a huge number of children and adults and this is just one case that’s come up,” he warns.
“The most interesting thing is what we can learn about this particular child – the child’s immune system and genetics and whether there’s anything that can teach us why the child may have been able to control the virus. It’s these lessons that can inform how we develop vaccines that will be effective for everyone.” S
Dr Avy Violari Professor Caroline Tiemessen