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9 Years Old South African Child Virtually Cured Of HIV

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A 9-year-old South African child diagnosed with HIV when he was 1 month old has been in HIV remission for 8½ years — without regular treatment. This is the first reported case of a child controlling their HIV infection without drugs in Africa and the third known case globally.

The child was placed was placed on antiretroviral treatment, or ART after diagnosis for 40 weeks at which point treatment was stopped and the child’s health was monitored.

Blood tests in late 2015 revealed the child is in HIV remission, meaning levels of the virus in the blood are undetectable using standard tests. Subsequent testing of samples dating back to the child’s infancy confirm remission was achieved soon after treatment was stopped.
Treatment was paused as part of a larger research trial investigating the potential for early ART to decrease infant mortality and reduce the need for lifelong treatment among newborns infected with HIV.
“This is really very rare,” said Dr. Avy Violari, head of pediatric clinical trials at the Perinatal HIV Research Unit at the University of Witwatersrand in South Africa. Violari is the child’s doctor and presented the findings at the 9th International AIDS conference on HIV Science in Paris on Monday. “By studying these cases, we hope we will understand how one can stop (treatment),” Violari said.
The child, who was not identified, was part of a study known as the Children with HIV Early Antiretroviral Therapy, or CHER, trial, which ran from 2005 to 2011. More than 370 infants infected with HIV were randomly assigned to immediately receive ART for either 40 weeks or 96 weeks. A third group were not placed on immediate treatment, but instead received treatment according to standard guidelines at the time.
When the trial began, standard treatment was based on the level of immune cells damaged by the virus, known as CD4 cells, within the body. Current guidelines recommend immediate treatment, irrespective of CD4 cell count.
In infants infected with HIV close to birth, progression of the disease occurs very rapidly within the first few months of life and can often lead to death, according to the World Health Organization. An estimated 110,000 children died of AIDS-related illnesses in 2015, according to UNAIDS.
Pediatricians also worry about the side-effects and health impacts of lifelong treatment with antiretroviral drugs for those who survive.
More than 1.8 million children were living with HIV in 2015, according to UNAIDS, and 150,000 children became newly infected, the majority of which were in Africa.
The study found mortality decreased by 76% and HIV disease progression reduced by 75% among the infants who received treatment immediately, for 40 or 96 weeks. The group receiving standard treatment saw an increase in mortality based on interim results, so that arm of the trial was stopped early.
Children receiving early treatment in the trial needed to go back onto it, on average, after two years, Violari said, with cases ranging from needing it immediately to needing it after four years. An estimated 10 children have not had to go back on treatment, she said, as their viral loads are fairly low — between 1,000 to 3,000 per milliliter of blood — meaning they are healthy, in clinical terms.
But virus levels in the 9-year-old case are undetectable. “The child is the only child showing remission,” said Violari. “We cannot see virus in the blood using standard techniques … we can see fragments of the virus in the cells,” she said, adding that these fragments appear not to be able to replicate, for now, giving hope the child may stay this way. “This child is unique.”

The Three Cases:

The South African child is the third reported case of long-term HIV remission in a child after early, limited treatment with antiretroviral drugs.

The first case was a Mississippi baby, a girl born in 2010, who received ART just 30 hours after birth until she was 18 months old, at which point HIV remission was achieved. The baby sustained remission for 27 months, until 2015, when she rebounded and the virus was found in her blood.

The second is a a French teenager, now 20, whose mother was HIV positive. The French child was given antiretroviral treatment soon after birth, stopped treatment at age 6 and has maintained undetectable levels of the virus in her blood since.

 

 

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About Author

Akin Akingbala is an international journalist based in Lagos, Nigeria. Aside being happily married, he has interests in music, sports and loves traveling.

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