Early antiretroviral treatment reduces viral reservoirs in HIV-infected teens

March 4, 2013

A study led by University of Massachusetts Medical School professor and immunologist Katherine Luzuriaga, MD, and Johns Hopkins Children's Center virologist Deborah Persaud, MD, highlights the long-term benefits of early antiretroviral therapy (ART) initiated in infants.

The study, presented on March 4 at the 20th annual Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta, shows that ART administered in early infancy can help curtail the formation of hard-to-treat viral sanctuaries—reservoirs of "sleeper" cells responsible for reigniting infection in most HIV patients within weeks of stopping therapy.

The report describes nine teenagers, five of whom started ART around two months of age. Ultrasensitive testing showed dramatically lower copy numbers of in the five teens who received ART within two months of exposure compared to the four teens who started treatment at a later age. In addition, serial testing demonstrated a small decay in the amounts of HIV DNA in the blood of the early-treated children over time. Moreover, using very sensitive techniques, the researchers were not able to recover HIV from the early-treated teens. In contrast, detected viral hideouts in the late-treated teens. Four of the five early-treated children showed no HIV-specific antibodies on standard testing, but antibodies were detected in the blood of all four who started treatment late.

In a related report, Dr. Luzuriaga and Dr. Persaud reported on March 3 the case of an infant who underwent remission of after receiving ART within 30 hours of birth. Altogether, these findings, the researchers say, can help pave the way toward achieving long-term viral suppression without treatment in children. Long-term without treatment is an exceedingly rare phenomenon observed in so-called "elite controllers," HIV-infected patients whose immune systems are able to rein in and keep the virus at clinically undetectable levels even without treatment. HIV experts have long sought a way to help all achieve such elite-controller status.

"Preventing mother-to-child transmission remains our primary goal but these studies provide the impetus for further studies aimed at curing children if they do acquire infection," says Luzuriaga.

Luzuriaga, a professor of pediatrics and molecular medicine at UMass Medical School, has been investigating maternal-fetal transmission and pediatric HIV since the disease was first identified. Her laboratory focuses on the immunopathogenesis of persistent viral infections in humans, and the development of prophylactic and therapeutic vaccine strategies for HIV.

Explore further: Researchers describe first 'functional HIV cure' in an infant

More information: Her recent paper in the Journal of Virology (Identification of ongoing human immunodeficiency virus type 1 (HIV-1) replication in residual viremia during recombinant HIV-1 poxvirus immunizations in patients with clinically undetectable viral loads on durable suppressive highly active antiretroviral therapy. J Virol. 2009 Oct; 83(19):9731-42.), is an example of her laboratory's work in understanding the persistence of HIV infection.

Her 2004 New England Journal of Medicine report (A trial of three antiretroviral regimens in HIV-1-infected children. N Engl J Med. 2004 Jun 10; 350(24):2471-80.) indicated that at an age of three months or younger, initiation of therapy and treatment with stavudine, lamivudine, nevirapine, and nelfinavir were associated with improved long-term viral suppression.

Related Stories

Researchers describe first 'functional HIV cure' in an infant

March 3, 2013
A team of researchers from Johns Hopkins Children's Center, the University of Mississippi Medical Center and the University of Massachusetts Medical School describe the first case of a so-called "functional cure" in an HIV-infected ...

Early temporary treatment for HIV can delay the time to long-term treatment

March 27, 2012
A study in this week's PLoS Medicine suggests that when people are first infected with HIV (primary HIV infection), temporary treatment with antiretroviral drugs (cART) for 24 weeks can delay the need to restart treatment ...

Recommended for you

Candidate AIDS vaccine passes early test

July 24, 2017
The three-decade-old quest for an AIDS vaccine received a shot of hope Monday when developers announced that a prototype triggered the immune system in an early phase of human trials.

Girl's HIV infection seems under control without AIDS drugs

July 24, 2017
A South African girl born with the AIDS virus has kept her infection suppressed for more than eight years after stopping anti-HIV medicines—more evidence that early treatment can occasionally cause a long remission that, ...

Meds by monthly injection might revolutionize HIV care (Update)

July 24, 2017
Getting a shot of medication to control HIV every month or two instead of having to take pills every day could transform the way the virus is kept at bay.

Paris spotlight on latest in AIDS science

July 21, 2017
Some 6,000 HIV experts gather in Paris from Sunday to report advances in AIDS science as fading hopes of finding a cure push research into new fields.

Scientists elicit broadly neutralizing antibodies to HIV in calves

July 20, 2017
Scientists supported by the National Institutes of Health have achieved a significant step forward, eliciting broadly neutralizing antibodies (bNAbs) to HIV by immunizing calves. The findings offer insights for HIV vaccine ...

Heart toxin reveals new insights into HIV-1 integration in T cell genome

July 20, 2017
Human immunodeficiency virus (HIV)-1 may have evolved to integrate its genetic material into certain immune-cell-activating genes in humans, according to new research published in PLOS Pathogens.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.