A South African nine-year-old is the world’s third child born with HIV to go into remission, scientists have said.
The child has had a healthy immune system for more than eight years after receiving a short course of treatment in early life, according to a new study.
Researchers believe aggressive treatment soon after infection could enable long-term remission of the disease – which, if it lasts, would be a form of cure for the deadly virus.
HIV-positive individuals must take daily antiretroviral drugs (ART) for their whole lives to control the infection’s progression.
But experts were surprised by the results of the clinical trial, presented at a conference in Paris, which appears to have left the child with no need for medication.
The study was sponsored by the US National Institute of Allergy and Infectious Diseases, which previously found that early treatment helped babies survive.
Researchers did not identify the minor but said they started on HIV drugs when they were two months old and stopped 40 weeks later.
Tests when the child was nine and a half years old found signs of the virus in a small number of immune system cells, but none capable of reproducing.
The child does not have a gene mutation that gives natural resistance to HIV infection, the researchers said, so remission seems likely due to the early treatment.
Experts have stressed the case is extremely rare, and does not suggest a simple path to a future cure for Aids, which killed an estimated 1.1 million people worldwide in 2015.
Linda-Gail Bekker, president of the International Aids Society, said the study raises the “interesting notion that maybe treatment isn’t for life” but was “clearly a rare phenomenon”.
“It’s a case that raises more questions than it necessarily answers,” she told Reuters.
So far, similar results have been seen in two other children, one in the US and another in France.
A French woman who was born with HIV and is now around 20 has had her infection under control despite no HIV medication since she was around six years old.
And the infection was suppressed in a baby born with the virus in Mississippi in 2010 for 27 months after stopping treatment before it reappeared in her blood. She was able to control the virus again after treatment resumed.
Around 18 million people – half of all those living with HIV around the world – take ART, which can cause unpleasant side effects.
These drugs could in future be replaced with six yearly injections that slowly and continuously release HIV medication into the blood, scientists also revealed in separate research.
At least a dozen adults have had remissions lasting for years after stopping HIV medication.
A study under way 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 experiment with stopping treatment later this year.
Access to drugs and fewer people being infected with HIV have led to a steep fall in the number of deaths related to the virus, according to the World Health Organisation. In 2015, 45 per cent fewer people died of the virus compared to in 2005.
Dr Michael Brady, medical director of the Terrence Higgins Trust, said the case report was “really interesting” and called for further research into the phenomenon.
“Early HIV therapy, in both children and adults, has been shown to reduce some of the damage to the immune system that HIV causes in the first few weeks and months of infection,” he said.
“If we can understand this mechanism better it will hopefully lead to novel treatment strategies and, maybe one day, a cure.
“Further research is needed, but this case adds to the hope that, one day, we may be able to prevent the need for life-long therapy with a short course of early HIV treatment in infancy.
“For now, however, early diagnosis and life-long treatment for HIV remain our best options for fighting the epidemic.”
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