The research on early antiretroviral therapy has led to the fact that treatment of the virus during infancy may suppress HIV to undetectable levels which could reduce the need for life-long drug therapy. In the study, before treatment, the child’s levels of HIV in the blood, or viral load, were very high. At around 9 weeks of age, the child started ART, which suppressed the virus to undetectable levels. The child’s treatment was halted at 40 weeks, and their immune health was monitored during years of follow-up examinations.
Investigators assessed the child’s immune health and the presence of HIV at age 9.5 years. They found a reservoir of virus in a tiny portion of immune cells, but otherwise no evidence of HIV infection was detected and there were no associated symptoms.
While the researchers detected a trace of response by the immune system, they were unable to identify any HIV capable of replicating. It was confirmed that the child does not have genetic characteristics connected with spontaneous HIV control, which suggests that the 40 weeks of ART received during infancy may have played a key role in achieving HIV remission.
Since the initial treatment, the child has maintained undetectable levels of HIV. “To our knowledge, this is the first reported case of sustained control of HIV in a child enrolled in a randomized trial of ART interruption following treatment early in infancy,” says Dr. Avy Violari, head of pediatric research at the Perinatal HIV Research Unit at the University of the Witwatersrand in Johannesburg, South Africa, co-led the study with Mark Cotton, head of the Division of Pediatric Infectious Diseases at Stellenbosch University, also in South Africa.