Posted on | November 27, 2013 | No Comments
Rwanda says it has become the first country to launch a nationwide campaign to “non-surgically” circumcise 700,000 men in an attempt to cut rates of HIV infection.
The health ministry said circumcision was a crucial part of its strategy for achieving an Aids-free generation in Rwanda, where the adult HIV rate of 2.9% is already among the lowest in Africa.
Agnes Binagwaho, the health minister, said at the project’s launch: “Rwanda is the first country to launch non-surgical adult male circumcision with an aim of reducing HIV infection.”
The ministry said it aimed to circumcise 700,000 males between the ages of 15 and 49 across the country by the end of 2016. It is receiving support from the Global Fund to Fight Aids, Tuberculosis and Malaria, the US and the UN.
Non-surgical circumcision involves the use of a plastic device called PrePex, comprising two rings and an elastic band, that cuts off blood supply to the foreskin, which loses sensation and shrivels, similar to the process of removing the umbilical cord of a newborn child. The PrePex has to be worn for a week, after which it is removed and the dead foreskin is cut off.
Its makers claim that men “can resume work and almost all daily activities shortly after the procedure”, with the device “designed to be placed, worn, and removed with minimal disruption”, although they should abstain from sex for six weeks afterwards.
The PrePex was approved by the World Health Organisation in May after three years of clinical trials and has also been cleared by the US Food Drug Administration. Binagwaho said it had been “clinically validated as a bloodless procedure that doesn’t necessitate injected anaesthesia”.
Studies have found that voluntary medical male circumcision reduces the risk of heterosexually acquired HIV/Aids infection by roughly 60%. The PrePex, made by an Israeli company, Circ MedTech, is already being used in Botswana, Kenya, Mozambique, South Africa, Uganda, Zambia and Zimbabwe.
Concerns have been raised about its price, usually around $20 (£12.34). Unitaid, a global health initiative to raise funds, has said more market competition is needed to make PrePex affordable for supply to the world’s poorest people.
Posted on | November 26, 2013 | No Comments
The World Health Organisation has been forced to retract claims that crisis-hit Greeks are intentionally injecting themselves with the HIV virus to collect state benefits almost two months after the shocking allegation was revealed in a report that triggered global media coverage.
Blaming the mistake on an “editing error”, the Geneva-based body issued an unreserved apology on Tuesday, saying it had been wrong to claim that “about half” of the debt-stricken country’s new HIV infections had been self-inflicted.
“The report incorrectly states that, in Greece, ‘HIV rates and heroin use have risen significantly, with about half of new HIV infections being self-inflicted to enable people to receive benefits of €700 per month and faster admission on to drug substitution programmes’.
“This statement,” it continued, “is the consequence of an error in the editing of the report.”
As outrage grew, not least in Greece, the international agency issued a second mea culpa in which it not only apologised for the error but offered further clarification. “The [offending] sentence should read, “Half of the new HIV cases are self-injecting and out of them few are deliberately inflicting the virus’.”
“This was just a gross editing error for which the WHO apologises,” said its spokesman, Gregory Hartl.
Earlier, Hartl had taken to Twitter where he attributed the mistake to a “typo”, adding: “People are not giving themselves HIV in Greece to get benefits.”
Published in September by WHO’s European office, the report was based on findings prepared by University College London’s Institute of Health Equity.
Part of a bigger survey on Europe‘s growing health divide, the agency said the claim had been based on observations made in 2011 by a Greek researcher in the medical journal The Lancet.
Greece’s prolonged economic crisis – the nation is now mired in a sixth straight year of recession – has sparked a public health crisis that has seen infectious diseases soar.
The HIV rate has nearly tripled over the past decade, according to the Hellenic Centre for Disease Control and Prevention (Keelpno).
Last week, in one of the most dramatic signs yet of the toll the debt drama is having, the National School of Public Health announced that the life expectancy of Greeks had dropped from 81 to 78 years since the outbreak of the crisis four years ago. Suicides and homicides have also shot up as Greeks grapple with record rates of unemployment (at 27% the highest in the eurozone) and deepening poverty.
“In a climate that is very negative drug users in particular have become ever more self-destructive,” said Babis Poulopoulos, Greece’s leading authority on drug rehabilitation. “To say that people are deliberately injecting themselves with HIV, however, is absurd. It’s not benefits which are their incentive, it’s life. They have lost the motivation to live,” he told the Guardian.
As a result of internationally mandated cuts, the country, which has been forced to survive on EU-IMF rescue funds since May 2010, has not only slashed hospital budgets but welfare benefits.
Government records show that monthly handouts have dropped from €700 to €569 for HIV carriers in the past year.
Posted on | November 26, 2013 | No Comments
26 November 2013
Last updated at 11:01 ET
Half of new HIV infections in sub-Saharan Africa are among young people
Government grants in South Africa are helping poor girls resist the advances of older men, reducing the risk of getting HIV, a study says.
The Oxford University study found that girls from homes which received child support grants were two-thirds less likely to date older men for money.
Young girls are up to three times more likely to become infected with HIV than boys in South Africa, experts say.
Local officials see “sugar daddies” as a major factor in the spread of Aids.
South Africa has more people living with HIV than any other country.
A team of researchers from universities including UK’s Oxford University and South Africa’s Witwatersrand University interviewed more than 3,500 teenagers from two provinces in the country over a period of three years.
According to the study, teenage girls from households which received child support grants are less likely to sleep with an older man in exchange for money, food or school fees than those from homes which did not receive the benefit.
“This study shows that as long as they are given enough money to survive, girls will choose not to have a sugar daddy,” said Lucie Cluver of the University of Oxford.
The study, published in the medical journal, Lancet Health Global Health, found that around 15% of teenagers were engaging in risky sexual behaviour such as unprotected sex, multiple partners or sex while under the influence of drugs or alcohol.
“Child support grants do not make teenagers more sensible when it comes to safer sex,” said Mark Orkin from the University of the Witwatersrand, in a statement.
“But what they can do is to provide enough financial security for girls that they do not have to choose their sexual partners through economic necessity,” he said.
Granting a better future?
Health Minister Aaron Motsoaledi recently identified “sugar daddies” as one of the biggest threats to the country’s attempts to curb the spread of Aids.
Because of the skewed balance of power in many of these relationships, girls are often pressured to have sex without a condom, says the BBC’s Pumza Fihlani in Johannesburg.
But this study seems to suggest that these government a slowly empowering teenagers in poor communities, who are most at risk.
“It also shows how valuable it is to give [grants] not only to younger children but also to teenagers, who are most at risk of HIV infections,” said Ms Cluver.
South Africa has one of the world’s highest HIV infection rates and currently runs the world’s largest antiretroviral program.
Local experts say new infections have decreased in recent years, which could indicate that young people are changing their sexual behaviour.
About 11 million children are currently receiving a child support grant, which is given to poor families who have shown that they are struggling to survive.
Each eligible child receives a monthly grant of 300 rand ($30; £19) and a foster child grant of 800 rand.
Posted on | November 22, 2013 | No Comments
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By Stephanie Nebehay
GENEVA (Reuters) – More than a quarter of a million children each year are born infected with the virus that causes AIDS, but too few are being tested early to receive treatment and prolong their lives, the United Nations said on Wednesday.
Michele Sidibe, executive director of UNAIDS, called for diagnostic kits to be improved for detection in babies of the Human Immunodeficiency Virus (HIV) that causes AIDS, and for their “still high” current price of $25-50 to be brought down.
Children are the “forgotten” victims of the AIDS epidemic, yet 260,000 babies joined their ranks last year, mainly in sub-Saharan Africa, he said.
“Irrespective of the market size we need to make sure that diagnostics are made available for children,” he told a news conference in Geneva ahead of World AIDS Day on December 1.
“We made a lot of progress during the last 2-3 years in terms of treatment, in terms of medicines, in terms of making sure that the molecules are more well-targeted for children. But where we are failing is also making early diagnostics.”
U.S.-based Abbott Laboratories and Swiss drugmaker Roche are among the main manufacturers of HIV diagnostics, according to senior UNAIDS officials.
Some 3.3 million children under age 15 have HIV, but only 1.9 million of them require treatment today, according to the Geneva-based agency. Fewer than 650,000 or 34 percent of the 1.9 million received antiretroviral AIDS drugs in 2012, still a rise of 14 percent from the year before, it said.
Some 14 million adults with HIV need treatment, and 9 million of them or 64 percent are receiving it, a far higher coverage rate than for children.
UNAIDS has identified 22 priority countries for stopping infections in children, 21 of them in sub-Saharan Africa, home to 90 percent of women living with HIV. The other is India.
In three of these priority countries – Chad, Democratic Republic of Congo and Malawi – fewer than 5 percent of infants at risk are being tested for HIV at birth, UNAIDS says.
“In priority countries, only 3 in 10 children receive HIV treatment. We have seen tremendous political commitment and results to reduce mother-to-child transmission but we are failing the children who become infected,” said Sidibe, who is from Mali.
All children under five who test positive for the virus should be put on treatment, according to Mahesh Mahalingam, UNAIDS director for its global plan for stopping new infections in children.
Current PCR tests are able to detect the virus in a baby only after the age of six weeks and require sending a blood sample to a specialized laboratory, he said.
“What we looking for are easier tests that we can administer earlier on, this will help detect the virus and start them on medicines faster. We recommend that as soon as the child is known to be HIV positive, you start on anti-retroviral drugs,” Mahalingam told Reuters.
He added: “The earlier we can diagnose, the earlier we can treat them which increase chances of child survival. Children are now getting to grow into adults. If we start pretty early they have the same chance of living as any other children.”
(Editing by Kate Kelland and Ralph Boulton)
Article source: http://www.nlm.nih.gov/medlineplus/news/fullstory_142730.html
Posted on | November 21, 2013 | No Comments
20 November 2013
Last updated at 19:31 ET
In Kenya 1.5 million people are living with HIV, and there are about 100,000 new infections every year. Despite this, some sex workers are having unprotected sex – and taking antiretroviral drugs afterwards to cut the infection risk. How reckless is this?
“Let me tell you the truth about why many of us don’t use condoms,” says Sheila who has been a prostitute in Nairobi’s Korogocho slum for six years.
“We don’t have money, and when you meet a client who offers to give you more money than you usually get, you have sex without protection even when you don’t know his HIV status.”
Sheila says she and other prostitutes can go to a clinic the next morning to get emergency antiretrovirals – drugs which suppress the virus, if taken within 72 hours of infection, and in many cases stop its progression.
Continue reading the main story
I had unprotected sex when I was very drunk one night… and lied that I was forced into it”
Pamela (sex worker)
“We use this medicine like condoms,” she says.
The type of antiretroviral in question is known as post-exposure prophylaxis, or PEP.
It is intended to be used in emergencies. For example, it is given to victims of rape if their attacker is thought to be HIV-positive, or to medics who have been pricked by a potentially infected needle.
There are no definitive figures to show how well PEP works. It’s far better, experts say, to prevent exposure the virus in the first place, by using condoms.
Continue reading the main story
Antiretroviral drugs (ARVs)
- Antiretroviral therapy (ART) – treatment for HIV positive patients
- Post-exposure prophylaxis (PEP) – emergency drug reduces risk of infection after exposure
- Pre-exposure prophylaxis (PrEP) – taken daily to reduce chance of getting infected
- ARVs can be given to pregnant and breastfeeding women, to prevent mother to child transmission
Some clinics will only give clients one course of PEP a year. They worry that if they hand the drugs out too freely, prostitutes will stop using condoms altogether.
This hasn’t stopped 24-year-old sex worker Pamela using PEP four times in the past year.
“I had unprotected sex when I was very drunk one night and the following morning I didn’t go to the same clinic where I got the first PEP tablets… I went to a different clinic where they don’t have my records, and lied that I was forced into unprotected sex,” she says.
She didn’t finish the full course because of the side-effects. “You feel bad, like vomiting, dizziness, and generally you just feel sick,” she says. “So I stopped taking them.”
Peter Godfrey-Faussett, senior science adviser with UNAIDS, says there is a place for antiretrovirals among sex workers, but only when used in the right way.
“We know that despite fairly high rates of condom use in many sex-work communities, we still have very high rates of HIV so we need additional tools as well as what’s already happening,” he says.
However, emergency use of PEP is the wrong way to go about it, he says. Instead prostitutes should take a type of antiretroviral designed to be taken before exposure to HIV – known as Pre-exposure prophylaxis (PrEP).
These are taken daily, and contain fewer drugs than PEP, so there are fewer side effects. But Godfrey-Faussett stresses that they must be used as part of a wider package, including regular HIV testing to make sure that the patient is on the correct medication.
There are plans to run a pilot programme with sex workers in Kenya to see if it could be practical for them to use PrEP as an extra layer of defence.
Truvada was approved for use as a PrEP in the US in 2012
The drugs are not cheap, though.
In the US, PrEP costs around $14,000 (£8,700) a year at the full price, although people on low incomes can get it much cheaper, or even free.
In developing countries, where generic copies of the drugs are used, the cost may be about $150 (£93) a year.
Godfrey-Faussett stresses that the cheapest line of defence is, in this case, the strongest.
“Condoms are the single most effective way of preventing HIV, sexually transmitted infections and pregnancy,” he says. “PrEP is not a silver bullet that will suddenly take away all those other issues.”
Additional reporting by Alison Gee in London.
Zainab Deen’s report was featured on Newsday on the BBC World Service.
Posted on | November 21, 2013 | No Comments
Tom Hayes says he is ‘lucky’ to have got tested for HIV when he did
Around one in five people with HIV in the UK are unaware they have the virus, figures show.
According to Public Health England 21,900 people out of 98,400 with HIV do not know they have it.
Tom Hayes, 28, was diagnosed with the virus in 2011.
After finding out his partner had been cheating on him, Tom went for a sexual health check up, which came back clear. However, another one six months later, came back as HIV positive.
“When I was first diagnosed my brain refused to acknowledge it. I coped with it really well for the first few days until the reality dawned on me,” he said.
“I probably cried for two days straight.
“I wasn’t expecting anything to come back because I didn’t have any symptoms at all.”
According to Public Health England, 47% of the 6,360 people newly-diagnosed with HIV in 2012 were diagnosed at a late stage.
Gay men remain the group most affected by HIV, followed by black African men and women.
However, 2,880 of new cases in 2012 were among heterosexuals.
Tom says, initially, he didn’t think life would carry on as normal but that he’s probably healthier than he’s ever been, is in a happy relationship and only has to take one pill a day.
Getting checked early helped Tom increase his life expectancy.
“Putting it off never works,” he said. “You always have that niggling feeling in the back of your head that something might be wrong.
“I wasn’t expecting anything to come back because I didn’t have any symptoms at all. I’m really, really lucky, and glad, that I got tested when I did.”
Dr Steve Taylor is an HIV specialist at Heartlands hospital in Birmingham.
He says the new figures mean the illness could spread on without people realising.
“If they don’t know that they’re carrying it then they can pass it to their sexual partners.
Continue reading the main story
I wasn’t expecting anything to come back because I didn’t have any symptoms at all
“It’s not actually people who are tested and are on treatment who are passing HIV on, it’s those individuals who are, if you like, in blissful ignorance.”
Dr Taylor says 50% of people are diagnosed with HIV after the point when they should have started receiving therapy.
He is medical director of HIV awareness charity Saving Lives, which aims to raise awareness in people who have not been taught about HIV.
Dr Taylor thinks there should be more education in schools.
“I think there is still a lot of stigma surrounding HIV. In certain communities it’s still seen that HIV is something you’ve bought on yourself, you have loose morals, therefore people are very, very afraid to go for a test or talk about it.”
“It’s not until everybody knows somebody with HIV that they’ll actually realise that they’re just like you and I. “
Follow @BBCNewsbeat on Twitter
Posted on | November 1, 2013 | No Comments
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THURSDAY, Oct. 31 (HealthDay News) — Researchers who created the first map of human resistance to HIV say their achievement could lead to improved treatments for the virus, which causes AIDS.
When a person is infected with HIV, the immune system tries to destroy the virus. In order to thwart those attacks, HIV undergoes millions of genetic mutations a day. In most cases, this tactic enables HIV to defeat the immune system.
However, some people’s immune systems manage to hold HIV at bay without any treatment.
“The virus survives but replicates more slowly, and thus its capacity for destruction is in some sense neutralized,” study co-author Jacques Fellay, of the Swiss Federal Institute of Technology in Lausanne, said in an institute news release.
In this study, Fellay and fellow geneticists used a supercomputer to analyze immune system-triggered mutations in the genomes of a variety of strains of HIV from more than 1,000 patients.
The findings improve understanding of how the immune system tries to defend against HIV and how HIV adapts to that defense, according to the study published Oct. 29 in the journal eLife.
By studying people’s natural defenses against HIV, it may be possible to develop new treatments and individualized therapies that take into account patients’ genetic strengths and weaknesses, the researchers suggested.
Article source: http://www.nlm.nih.gov/medlineplus/news/fullstory_142089.html
Posted on | October 31, 2013 | No Comments
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WEDNESDAY, Oct. 30 (HealthDay News) — Providing early antiretroviral drug treatment for recently infected HIV patients and their uninfected sexual partners is a cost-effective way to help patients stay healthy and prevent transmission of HIV, a new study finds.
The study, published Oct. 31 in the New England Journal of Medicine, looked at HIV patients in India and South Africa. Some of the patients received early antiretroviral therapy while the start of treatment was delayed for other patients. HIV is the virus that causes AIDS.
During the first five years of the study, 93 percent of those who received early antiretroviral therapy survived, compared with 83 percent of those whose treatment was delayed. Life expectancy was nearly 16 years for those in the early treatment group, compared with nearly 14 years for those in the delayed treatment group.
During the first five years, the potential costs of infections — particularly tuberculosis — prevented by early treatment of HIV patients in South Africa outweighed the costs of antiretroviral therapy drugs, suggesting that the early treatment strategy would reduce overall costs.
This was not the case in India, where the costs of treating HIV-related infections are less. Even so, early antiretroviral therapy in India was projected to be cost-effective according to established standards, the researchers said.
They also found that across patients’ lifetimes, early antiretroviral therapy was very cost-effective in both countries. While most of the benefits of early treatment were seen in the HIV-infected patients — fewer illnesses and deaths — there were also added health care and economic cost savings from reducing HIV transmission, according to the study.
“By demonstrating that early HIV therapy not only has long-term clinical benefits to individuals but also provides excellent economic value in both low- and middle-income countries, this study provides a critical answer to an urgent policy question,” study corresponding author Dr. Rochelle Walensky, of the Massachusetts General Hospital Division of Infectious Disease, said in a hospital news release.
“HIV-infected patients live healthier lives, their partners are protected from HIV, and the investment is superb,” she added.
Walensky, a professor of Medicine at Harvard Medical School, said the findings point to a need to “redouble international efforts” to provide early antiretroviral therapy to any HIV-infected person who can benefit from it.
Her colleague, Dr. Kenneth Freedberg, director of the Medical Practice Evaluation Center at Massachusetts General, agreed.
“Some people have questioned whether providing early [antiretroviral therapy] to all who need it would be feasible in resource-limited countries,” he said in the news release. “We’ve shown that in countries like South Africa, where it actually saves money in the short-term, the answer is ‘yes.’ We believe that continued international public and private partnerships can make this true in other countries as well.”
Freedberg said such an investment could bring about dramatic decreases in infections and illness that could save millions of lives over the next decade.
Article source: http://www.nlm.nih.gov/medlineplus/news/fullstory_142056.html
Posted on | October 31, 2013 | No Comments
30 October 2013
Last updated at 20:02 ET
A potential new HIV treatment has a “profound and unprecedented” impact on the virus, according to animal studies published in the journal Nature.
Potent antibodies were able to wipe a hybrid of human and monkey immunodeficiency viruses from the bloodstream of monkeys within days.
The findings could “revolutionise” the search for an HIV cure, say experts.
The US researchers said trials in patients with HIV now needed to take place.
The immune system produces precisely targeted antibodies to take out HIV, but the virus is able to rapidly mutate to evade the immune assault.
Continue reading the main story
The effect with these potent antibodies is profound and unprecedented. It’s probably as large an antiviral therapeutic effect as has ever been seen”
Prof Dan Barouch
Harvard Medical School
However, some antibodies have been discovered that target the “conserved” parts of HIV – those that the virus struggles to change because they are vital for it to function.
Two groups, from Harvard Medical School and the National Institute of Allergy and Infectious Diseases, performed the first trials of these antibodies.
They used rhesus macaques that had been infected with simian-human immunodeficiency virus (SHIV), a blend of HIV and the monkey equivalent.
Data from the Harvard team showed that injection of the antibodies drove SHIV from the bloodstream until it reached undetectable levels after three to seven days.
The effect lasted for one to three months, but in three monkeys the virus did not return to the blood during the 250-day study.
Prof Dan Barouch told the BBC: “The effect with these potent antibodies is profound and unprecedented. It’s probably as large an antiviral therapeutic effect as has ever been seen.
“But we have to make sure we don’t overhype and the limitation is the study is in animals, not humans.”
The antibodies were also able to attack the virus in some tissues. Drugs can assault the virus in the blood during normal HIV treatment, but the virus can hide in other parts of the body.
These early findings raise the prospect of using antibodies to clear these tissues as well.
Similar results were produced by the team at the National Institute of Allergy and Infectious Diseases
HIV infection is incurable, although taking a daily dose of medication can keep the virus in check, giving patients a near-normal life expectancy.
The antibodies will be tested in human clinical trials and if successful they could be used alongside antiretroviral drugs as a treatment.
It may also be possible to devise a vaccine that could train the immune system to produce these antibodies.
However, both these ideas are dependent on human trials being successful.
Commenting on the findings, Prof Louis Picker and Prof Steven Deeks said: “The findings of these two papers could revolutionise efforts to cure HIV.”
However, they warned that HIV was so prone to mutation that it was “likely that some people will harbour viruses that are resistant to one or more” of the antibodies.
Posted on | October 24, 2013 | No Comments
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WEDNESDAY, Oct. 23 (HealthDay News) — A 3-year-old Mississippi girl apparently cured of HIV infection by aggressive treatment right after her birth remains free of the virus, her doctors report.
Early treatment with a combination of potent antiretroviral drugs appears to have kept the virus from successfully establishing a reservoir in the child’s system, said immunologist Dr. Katherine Luzuriaga, of the University of Massachusetts Medical School, who is part of the research team tracking the case.
Doctors are hesitant to declare the child fully cured, but in a case update reported in the Oct. 24 issue of the New England Journal of Medicine they said that no actively replicating HIV has been found in her system by even the most sensitive tests available. The girl stopped taking HIV medication when she was 18 months old.
A couple of tests have found very low-level indications of HIV in the girl’s blood, but doctors cannot tell if they are false positives or simply remnants of the eradicated virus.
“If they are remnants, the question is whether they are capable of reigniting,” Luzuriaga said. “For that reason, we are calling this a remission because we want to follow the baby over a longer period of time to see if the child continues to control the virus without rebound.”
The girl stands as the first documented case of HIV remission in a child. Early findings in the case were first presented in March during a scientific meeting in Atlanta, but the new report adds critical details.
The girl’s pediatrician, Dr. Hannah Gay, of the University of Mississippi Medical Center, launched HIV treatment just 30 hours following her birth, according to the report.
Doctors normally put HIV-positive mothers on two antiretroviral medications prior to birth as a way of preventing transmission of the virus to their unborn children, Luzuriaga said. After delivery, doctors test the newborns for HIV and continue treatment if the virus appears.
But in this girl’s case, no one knew the mother was HIV-positive before delivery and the girl was born infected. This led Gay to put the newborn on antiretroviral treatment immediately, and that timing appears to have made a difference.
Gay also chose to employ a combination of three antiretroviral drugs, all at doses commonly used to treat HIV-infected infants, and kept the girl on the medications until she was 18 months old. This prevented the virus from mounting any drug resistance before it could be wiped clean from her body, Luzuriaga said.
Tests showed progressively diminishing HIV levels in the infant’s blood, until it reached undetectable levels 29 days after birth. The child remained on antiretrovirals until 18 months of age, at which point doctors said they lost track of her and she stopped treatment.
Doctors next saw her about 10 months after her treatment ceased. The child underwent repeated standard HIV tests, which detected no virus in her blood.
The two factors — timing and medication — appear to have prevented HIV from gaining a foothold in the girl’s immune system. The virus was unable to create a reservoir in her body in which dormant HIV can hide and later reignite when drug therapy is suspended.
“What studies in other babies have shown us is if you treat very early, you’re not only able to treat the viral replication but also able to limit the number of cells in which HIV integrates itself into the host genes,” Luzuriaga said. “Basically, HIV makes copies of DNA and that DNA integrates itself into host genes. That’s the barrier to cure. As long as you have those white blood cells floating around the body that have HIV stitched into the host DNA, the patient is not cured.”
A key point is that the child exhibits none of the immune characteristics seen in “elite controllers,” the tiny percentage of HIV-infected people whose immune systems are so active that they can keep the virus in check without treatment, the researchers said. The absence of these characteristics indicates that early therapy — rather than natural immune mechanisms — led to the child’s remission.
Based on this girl’s case, a federally funded study set to begin in early 2014 will test the early treatment method to determine whether the approach could be used in all HIV-infected newborns.
This method could cure newborns infected with HIV but is unlikely to help adults, given that they rarely learn of their infection until months or years after transmission, said Dr. Rowena Johnston, vice president of research at the Foundation for AIDS Research (amfAR).
“If there is something key to treating HIV within the first couple of days of transmission, it’s going to be incredibly difficult to treat adults in this manner,” Johnston said. “But this case really opens up the possibility that there may be different HIV cures for different populations, depending on what the circumstances are.”
Dr. Michael Horberg, director of HIV/AIDS treatment and research for Kaiser Permanente, agreed that the infant’s case is very encouraging, but said it’s not an indication of a potential cure for all people with HIV.
“This is a very unique situation, but it does show that very early treatment is very successful,” Horberg said. “We can envision potential future pathways with correct medication and vigilance where there might be a percentage of patients who could be successfully treated.”
Only one other instance of an HIV cure has been documented, in the so-called “Berlin patient.” An American man living in Germany received a bone marrow transplant for leukemia, with cells from a donor who had a rare genetic mutation that increases immunity against HIV. This patient has remained HIV-free after discontinuing drug therapy.
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