HIV Treatment: The Three Children Who Have Gone into HIV Remission After Early Treatment Against Disease

AIDS medication
An AIDS patient in Miami displays her cocktail of 14 different medications that she takes three times a day, on July 11, 2002. Joe Raedle/Getty

HIV sufferers usually require daily treatment for the rest of their lives to control the symptoms of the debilitating disease.

But researchers got a massive boost on Monday when it was announced that a 9-year-old South African child had been in remission for eight and a half years, without having to use antiretroviral drugs, after receiving intense treatment shortly after birth.

The child, whose identity is being protected, was born in 2007 and caught the virus from the mother, the BBC reported. The child was put on a clinical trial at 9 weeks old and received antiretroviral therapy for 40 weeks. The child was one of 143 children to receive the short course of drugs; another received 96 weeks’ worth of treatment. At the time, the use of ART for treating children with HIV was not standard practice.

Following the 40-week treatment period, levels of the virus became undetectable in the child’s blood. This has remained the case until the present, and the child has not had to undergo further treatment.

“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,” said Avy Violari of the Perinatal HIV Research Unit of the University of the Witwatersrand in Johannesburg, according to The Guardian. Violari presented the case study Monday to the International AIDS Society Conference in Paris.

HIV, or human immunodeficiency virus, attacks the body’s immune system, making sufferers susceptible to a variety of infections and diseases. AIDS, or acquired immunodeficiency syndrome, refers to a set of symptoms and illnesses that constitute an advanced stage of HIV. Antiretroviral therapy has advanced so much that the majority of HIV-positive people can take the drugs without major hindrances, but some people still suffer damaging side effects. These can include nausea, vomiting, insomnia, and anemia.

“Technically, this baby is not totally cured of HIV, but it is certainly what is referred to as remission, in that there’s no virus circulating in the blood, and there is a normal immune system according to the range for children of their age,” says Sarah Fidler, speaking on behalf of the British HIV Association to Newsweek.

Fidler says it is important that HIV-positive people do not stop taking antiretroviral drugs as a result of the case. Usually, children remain on ART throughout their life and do not stop after a set period. Fidler says the only reason the South African 9-year-old did so is because the child was part of a randomized trial.

Kenya HIV center The Kenwa center for HIV-positive women, made possible by donor funding, is pictured in Nairobi, Kenya, on December 1, 2006. Brent Stirton/Getty

“It is certainly not to be taken from this one person that we would then recommend that lots of people who’ve been treated since birth should think about stopping therapy. That’s definitely not the message to be taken from one case,” says Fidler, a reader and honorary consultant physician in HIV at Imperial College London.

She says that eradicating HIV transmission from mothers to children must be a global priority. About 150,000 children became infected with HIV in 2015; transmission rates from mother to child can be as high as 45 percent if pregnant women are not provided with ART.

Before Monday’s announcement, there had been only two documented cases of HIV-positive children going into remission after stopping ART.

The Mississippi Baby

A baby girl born in Mississippi in 2010 with HIV was started on a strong course of HIV treatment hours after her mother’s labor. The child did not receive any prenatal treatment and continued taking antiretrovirals until she was 18 months old. Doctors then lost track of the child, but 10 months later, she was tested again. Despite the fact she was no longer under treatment, the child showed no signs of infection with the virus.

2016-11-30T123625Z_2141162795_RC13EAFE3680_RTRMADP_3_AIDS-DAY People gather around lit candles in the shape of a ribbon during a HIV/AIDS awareness campaign ahead of World Aids Day, in Kathmandu, Nepal, on November 30, 2016. Navesh Chitrakar/Reuters

Fidler says that the South African child’s blood tests show a similar pattern to that of the so-called Mississippi baby. But after more than two years without HIV treatment, doctors confirmed in 2014 that the young girl was no longer in remission and had been restarted on ART after the virus re-emerged.

The Longest Case of HIV Remission in Children

A French girl born in 1996 contracted HIV either late in pregnancy or during the childbirth. The girl was treated for six weeks with a drug designed to stop the infection taking hold, but after the treatment was withdrawn, she suffered from high levels of HIV in her blood. The girl was then put on a course of ART for six years before coming off treatment at the age of 6.

At the International AIDS Society conference in Vancouver, British Columbia, in 2015, it was announced that the girl remained in remission 12 years after ending treatment. The girl is still thought to be in remission in what is believed to be the longest ever case of an HIV-positive child staying free of the virus after ending treatment.