Girl's HIV infection seems under control without AIDS drugs

July 24, 2017 by Marilynn Marchione
This undated photo provided by the Centers for Disease Control and Prevention shows a scanning electron micrograph of multiple round bumps of the HIV-1 virus on a cell surface. In a report released on Monday, July 24, 2017, researchers said a South African girl born with the AIDS virus has kept her infection suppressed for 8 1/2 years after stopping anti-HIV medicines—more evidence that early treatment can occasionally cause a long remission that, if it lasts, would be a form of cure. (Cynthia Goldsmith/Centers for Disease Control and Prevention via AP)

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, if it lasts, would be a form of cure.

Her case was revealed Monday at an AIDS conference in Paris, where researchers also gave encouraging results from tests of shots every month or two instead of daily pills to treat HIV.

"That's very promising" to help people stay on , the U.S.'s top AIDS scientist, Dr. Anthony Fauci, said of the prospects for long-acting drugs.

Current treatments keep HIV under control but must be taken lifelong. Only one person is thought to be cured—the so-called Berlin patient, a man who had a bone marrow transplant in 2007 from a donor with to HIV.

But transplants are risky and impractical to try to cure the millions already infected. So some researchers have been aiming for the next best thing—long-term remission, when the immune system can control HIV without drugs even if signs of the virus remain.

Aggressive treatment soon after infection might enable that in some cases, and the South African girl is the third child who achieved a long remission after that approach.

She was in a study sponsored by the agency Fauci heads, the National Institute of Allergy and Infectious Diseases, that previously found that early versus delayed treatment helped babies survive.

The girl, who researchers did not identify, started on HIV drugs when she was 2 months old and stopped 40 weeks later. Tests when she was 9 1/2 years old found signs of virus in a small number of immune system cells, but none capable of reproducing. The girl does not have a gene mutation that gives natural resistance to HIV infection, Fauci said, so her remission seems likely due to the early treatment.

The previous cases:

—A French teen who was born with HIV and is now around 20 has had her infection under control despite no HIV medicines since she was roughly 6 years old.

—A Mississippi baby born with HIV in 2010 suppressed her infection for 27 months after stopping treatment before it reappeared in her blood. She was able to get the virus under control again after treatment resumed.

At least a dozen adults also have had remissions lasting for years after stopping HIV medicines.

A study underway now is testing whether treating HIV-infected newborns within two days of birth can control the virus later after treatment stops. It started in 2014 in South America, Haiti, Africa and the United States, and some of the earliest participants might be able to try stopping treatment later this year.

Treatment might get easier if two large studies underway now confirm results reported Monday from a study testing a long-acting combo of two HIV drugs—Janssen's rilpivirine and ViiV Healthcare's cabotegravir.

Cabotegravir is experimental; rilpivirine is sold now as Edurant and used in combination with other drugs for treating certain types of HIV patients.

After initial treatment to get their virus under control, about 300 study participants were given either daily combination therapy pills or a shot every four or eight weeks of the long-acting drug duo to maintain control.

After nearly two years, 94 percent on eight-week shots, 87 percent on four-week shots and 84 percent on daily pills had their infections suppressed, with similar rates of side effects.

"The results were good regardless of whether people came monthly or every two months for their treatment. This has important policy implications," said Dr. Linda-Gail Bekker, deputy director of the Desmond Tutu HIV Centre at the University of Cape Town in South Africa, and a co-leader of the conference.

The study was sponsored by the drugmakers. Results were published in the British medical journal Lancet.

Two large studies aimed at winning approval to sell the treatment are testing the monthly shots. Janssen said in a statement that good results from eight-week shots warrant reconsidering the longer approach.

If it works, "this will have a huge impact on how we manage that very important group of people who are not able to access and take drugs on a day-to-day basis," such as those with mental health or abuse problems, said Dr. Steven Deeks, an AIDS specialist at the University of California, San Francisco.

Explore further: Paris spotlight on latest in AIDS science

More information: Reference: A Violari et al. Viral and host characteristics of a child with perinatal HIV-1 following a prolonged period after ART cessation in the CHER trial. 9th IAS Conference on HIV Science, Paris (2017).

Related Stories

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.

Doctors hope for cure in a second baby born with HIV (Update)

March 5, 2014
A second American baby born with the AIDS virus may have had her infection put into remission and possibly cured by very early treatment—in this instance, four hours after birth.

Teen in remission from HIV 12 years after stopping meds

July 20, 2015
A French teenager born with HIV has been in remission for 12 years after stopping her medication, a world first that renews hope for the prospect of early treatment, researchers said Monday.

Studies show big promise for HIV prevention drug

March 4, 2014
Exciting research suggests that a shot every one to three months may someday give an alternative to the daily pills that some people take now to cut their risk of getting HIV.

AIDS scientists optimistic of AIDS cure, for some

May 22, 2013
Top AIDS scientists were optimistic Wednesday of finding a cure for the disease that has claimed 30 million lives—but said it might not work for all people.

J&J, ViiV: 2 injections every month or 2 could control HIV

November 3, 2015
Preliminary testing of two long-acting injectable drugs indicates it might be possible to keep HIV at bay indefinitely with injections every month or two.

Recommended for you

Study suggests a way to stop HIV in its tracks

December 1, 2017
When HIV-1 infects an immune cell, the virus travels to the nucleus so quickly there's not enough time to set off the cell's alarm system.

Discovery puts the brakes on HIV's ability to infect

November 30, 2017
Viewed with a microscope, the virus faintly resembles a pineapple—the universal symbol of welcome. But HIV, the virus that causes AIDS, is anything but that. It has claimed the lives of more than 35 million people so far.

Rising levels of HIV drug resistance

November 30, 2017
HIV drug resistance is approaching and exceeding 10% in people living with HIV who are about to initiate or reinitiate first-line antiretroviral therapy, according to the largest meta-analysis to date on HIV drug resistance, ...

Male circumcision and antiviral drugs appear to sharply reduce HIV infection rate

November 29, 2017
A steep drop in the local incidence of new HIV infections accompanied the rollout of a U.S.-funded anti-HIV program in a large East-African population, according to a study led by researchers at Johns Hopkins Bloomberg School ...

Combination HIV prevention reduces new infections by 42 percent in Ugandan district

November 29, 2017
A study published today in the New England Journal of Medicine provides real-world evidence that implementing a combination of proven HIV prevention measures across communities can substantially reduce new HIV infections ...

Research on HIV viral load urges updates to WHO therapy guidelines

November 24, 2017
A large cohort study in South Africa has revealed that that low-level viraemia (LLV) in HIV-positive patients who are receiving antiretroviral treatment (ART) is an important risk factor for treatment failure.

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.