A French teenager who has been HIV positive since birth was able to stop treatment for 12 years without having her disease progress, according to recently released findings.
Researchers from the Institut Pasteur in Paris presented their findings at the 8th International AIDS Society (IAS) Conference and said they are still trying to understand why the teen has been able to stay off HIV treatment without the virus becoming detectable again.
The teen was born in 1996 to an HIV-positive mother and underwent antiretroviral therapy for six years, according to researchers. Her family then decided to stop therapy, and when the girl was tested a year later her viral loads remained undetectable by the standard test ordered by her medical team. There is a chance that smaller amounts of virus could be detected with more advanced testing.
For the last 12 years, the girl has remained off drugs as doctors monitored her progress to see if she developed he disease. She is still considered HIV positive.
“This remission, however, should not be equated with a cure,” Professor Jean-François Delfraissy, director of France’s National Agency for Research on AIDS, said in a statement. “This young woman is still infected by HIV and it is impossible to predict how her state of health will change over time. Her case, though, constitutes a strong additional argument in favor of initiation of antiretroviral therapy as soon as possible after birth in all children born to [HIV positive] mothers.”
Researchers cited early treatment from birth as a possible explanation for how the teen was able to get stay off of medications starting at age 6
However, HIV experts pointed out that there have been other cases where patients were able to live without treatment for years and not have the virus become detectable.
In many of those cases the patients were determined to be “elite controllers” with specific genetic markers associated with the ability to either fight off HIV infection or not have any HIV infection progress.
Dr. Mark Kline, a pediatric AIDS specialist and the chairman of the Department of Pediatrics at Baylor College of Medicine, said he was skeptical that early drug intervention was the sole reason the teenager could control the virus later on, saying he has seen hundreds of infants get the same drugs early on and none had the same reaction she did. He said it’s possible there was some unknown genetic factor in either her immune system or the virus itself that stopped the HIV from progressing.
“Tens of thousands of infants who have been treated in the first few days of life for HIV and 99-plus percent do not experience what she has experienced,” Kline said. “I think there’s something to be learned from this [but] don’t jump to conclusions,” about a cure or potential drug therapy.
Kline added that there is a chance the teenager has another genetic trait that has led her to be able to keep HIV in check for long periods of time, meaning she might also be determined to be an “elite controller” with further study.
“There are probably a host of other genetic factors that have yet to be identified,” said Kline. “We just don’t know all of them just yet.”
He believes it’s likely that that the virus eventually will become detectable in the patient in the future, he said.
Dr. Deborah Persaud, a professor of pediatrics at Johns Hopkins School of Medicine, said the case is particularly important because the teenager contracted the virus at birth. Infants have less-developed immune systems and appear to be less able to develop an immune system that can “control” their HIV compared to adults who acquire the virus.
“It’s a very important case,” Persaud said. “It’s not something that seems a common event in pediatric infection. It’s important to know about these cases and learn from these cases.”
She said the case is interesting but not likely to lead to a cure soon.
“The biggest message is that this is a very uncommon event, it’s a very, very rare event,” she told ABC News. “We don’t want parents to take their kids off treatment. We don’t expect the majority of 99 percent of kids” to have this reaction.
With continued study, she said, it may be possible someday to test HIV-positive infants to see if they have markers that would help protect them from developing a virulent strain of the HIV virus — but she cautioned that was a long way off.
