A South African child born with HIV and given a short course of treatment appears to have been cured of the AIDS virus after just a year of treatment followed by eight and a half years without further drugs, according to scientists at the International AIDS Society (IAS) conference in Paris.
Understanding how the child is protected could lead to a paradigm shift in the treatment of those infected with the disease.
Patients with HIV would normally need to stay on antiretroviral (ART) drugs for the rest of their lives to control the infection’s progress. But this child, still off treatment and now almost 10 years old, has no signs of the disease.
This and other recent, isolated cases of remission have given additional hope to the 37 million people worldwide infected with the virus that causes AIDS. Yet experts urged caution, saying the case is extremely rare and does not suggest a simple path to a cure.
“It’s a case that raises more questions than it necessarily answers,” said President of the IAS, Linda-Gail Bekker. “It does raise the interesting notion that maybe treatment isn’t for life. But it’s clearly a rare phenomenon.”
The unidentified child was part of a clinical trial in which researchers were investigating the effect of treating HIV-positive babies in the first few weeks of life, and then stopping and starting the ART medicines whilst checking whether their HIV was being controlled.
According to the researchers, they started ART treatment when the child was almost nine weeks old and stopped 40 weeks later when the virus had been suppressed, and the child was monitored regularly for any signs of relapse. At 9.5 years, the child was clinically asymptomatic.
The vast majority of patients with HIV suffer an increase in the amount of the virus circulating in the body if they stop treatment, but this child was different, according to the researchers.
“To our knowledge, this is the first case of sustained virological control from a randomised trial of ART interruption following early treatment of infants,” they said in a summary of findings presented at the IAS conference.
Sharon Lewin, an HIV expert at the University of Melbourne and Co-chair of the IAS’s HIV Cure and Cancer forum, said the case threw up possible insights into how the human immune system can control HIV replication when treatment is interrupted.
Yet in terms of the scientific search for a cure for HIV and AIDS, she told Reuters, it appeared only to confirm previous reports of similarly rare cases.
“We know that very rarely, people who have had treatment and stopped it are then able to control the virus,” said Lewin.
The HIV/AIDS pandemic has killed around 35 million people worldwide since it began in the 1980s. According to the United Nations HIV/AIDS agency, 19.5 million people are now on treatment.