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AIDS

French teen born with HIV stuns scientists

A French teenager born with HIV has been in remission for 12 years after stopping her medication, a world first that renews hope for the prospect of early treatment, researchers said Monday.

French teen born with HIV stuns scientists
A French teen born with HIV has become a world first after going into remission for 12 years. Photo: Philippe Huguen/AFP

The young woman, now 18, is not considered cured, but is doing perfectly well off treatment, said the research led by Asier Saez-Cirion of the HIV, Inflammation and Persistence Unit at the Institut Pasteur in Paris.

Never before have scientists known of a case in which an HIV-infected child goes into long-term remission, said the study presented at the International AIDS Society meeting in this western Canadian city.

“We can detect HIV in the cells, but what we cannot detect is viral replication in the plasma,” Saez-Cirion said in an interview.

“We don't know yet why this girl was able to control the infection.”

The girl does not have the genetic factors associated with natural control of infection, which has been seen in a rare group of patients.

“Most likely, she has been in virological remission for so long because she received a combination of antiretrovirals very soon after infection,” said the report.

The young woman, whose identity was not revealed, was infected with HIV either in utero or during childbirth.

When she was five, her family dropped out of the treatment program for unknown reasons. When they returned her to medical care one year later, she “was found to have an undetectable viral load,” said the report.

Doctors decided not to resume antiretroviral treatment for the child, but monitored her.

Researchers said the unconventional case bolsters growing evidence in adults that starting treatment immediately after HIV infection is essential.

Her case “suggests that long-term remission after early treatment is possible in children infected by HIV,” said the report.

Single case

There was a previous case of a baby who was born with HIV in the US state of Mississippi and went into an extended remission, but her case lasted only 27 months after antiretroviral therapy was stopped.

So researchers urged caution in interpreting the results, and said doctors do not recommend anyone stop their antiretroviral treatment.

“This case is going to be inspiring for people living with HIV and working in the field,” said scientist Sharon Lewin, who co-chaired a symposium earlier this week on finding a cure for HIV.

The meeting has drawn more than 6,000 HIV professionals from around the world.

“My reservations are, it's a single case,” Lewin told AFP.

“It's also uncertain whether the teen would have controlled (her HIV infection) without any treatment. We know one percent of people who become infected naturally control the virus and don't require treatment.”

The girl's case may not be unique, but it is the first identified by researchers, said Saez-Cirion.

“I'm sure there will be others in the future,” he said, noting there are still relatively few studies of children infected at birth who are now young adults and have been monitored for their entire lives.

Lewin cautioned that no one should become complacent about finding a cure in the face of growing evidence showing it is possible to treat HIV.

“The reality is there are still two million new infections and 1.5 million deaths a year from HIV and 35 million living with HIV,” said Lewin.

“Whether we can really fund that, sustain and keep people in lifelong care is unclear.”

Saez-Cirion said the findings offer direction for future research.

The case “shows that remission is possible, but rare. We need to understand why it's not common, and which mechanisms are (involved) so that we can treat a larger population.”

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HEALTH

Spanish scientists make breakthrough identifying HIV resistance gene

A rare genetic mutation that causes a form of muscular dystrophy affecting the limbs also protects against HIV infection, Spanish scientists reported Thursday.

Spanish scientists make breakthrough identifying HIV resistance gene
Photo: peshkova/Depositphotos

The breakthrough comes a decade after American Timothy Brown, known as the “Berlin Patient,” became the first person cured of HIV after a bone marrow transplant from a donor with a mutation of the CCR5 gene.

The newly-discovered mutation concerns the Transportin 3 gene (TNPO3) and is far more rare. 

It was identified several years ago among members of a family in Spain who were suffering from type 1F limb-girdle muscular dystrophy.   

Doctors studying the family learned that HIV researchers were interested in the same gene because it plays a role in transporting the virus inside cells.   


Role of TNPO3 in HIV infection (credit: Rodríguez-Mora S, et al., 2019).

They then got in touch with geneticists in Madrid, who took blood samples from those family members and infected the blood with HIV — revealing a welcome surprise.   

The lymphocytes — white blood cells that are an important part of the immune system — of people with the rare muscular illness were naturally resistant to HIV, it emerged.

“This helps us to understand much better the transport of the virus in the cell,” Jose Alcami, a virologist at the Carlos III Health Institute and co-author of a paper published in US journal PLOS Pathogens on the subject, told AFP.   

HIV is among the most studied viruses, he said, adding however that much remained to be learned, such as why five percent of patients who are infected do not develop AIDS.

“There are mechanisms of resistance to infection that are very poorly understood,” he said.

READ MORE: Spanish team develop biosensor to detect HIV within a week of infection

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