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A child with perinatal HIV infection and long-term sustained virological control following antiretroviral treatment cessation

Author

Listed:
  • Avy Violari

    (University of the Witwatersrand)

  • Mark F. Cotton

    (Stellenbosch University)

  • Louise Kuhn

    (Columbia University Medical Center)

  • Diana B. Schramm

    (National Institute for Communicable Diseases (NICD), of the National Health Laboratory Service (NHLS)
    University of the Witwatersrand)

  • Maria Paximadis

    (National Institute for Communicable Diseases (NICD), of the National Health Laboratory Service (NHLS)
    University of the Witwatersrand)

  • Shayne Loubser

    (National Institute for Communicable Diseases (NICD), of the National Health Laboratory Service (NHLS)
    University of the Witwatersrand)

  • Sharon Shalekoff

    (National Institute for Communicable Diseases (NICD), of the National Health Laboratory Service (NHLS)
    University of the Witwatersrand)

  • Bianca Da Costa Dias

    (National Institute for Communicable Diseases (NICD), of the National Health Laboratory Service (NHLS)
    University of the Witwatersrand)

  • Kennedy Otwombe

    (University of the Witwatersrand)

  • Afaaf Liberty

    (University of the Witwatersrand)

  • James McIntyre

    (Anova Health Institute
    Faculty of Health Sciences, University of Cape Town)

  • Abdel Babiker

    (University College London)

  • Diana Gibb

    (University College London)

  • Caroline T. Tiemessen

    (National Institute for Communicable Diseases (NICD), of the National Health Laboratory Service (NHLS)
    University of the Witwatersrand)

Abstract

Understanding HIV remission in rare individuals who initiated antiretroviral therapy (ART) soon after infection and then discontinued, may inform HIV cure interventions. Here we describe features of virus and host of a perinatally HIV-1 infected child with long-term sustained virological control. The child received early limited ART in the Children with HIV Early antiRetroviral therapy (CHER) trial. At age 9.5 years, diagnostic tests for HIV are negative and the child has characteristics similar to uninfected children that include a high CD4:CD8 ratio, low T cell activation and low CCR5 expression. Virus persistence (HIV-1 DNA and plasma RNA) is confirmed with sensitive methods, but replication-competent virus is not detected. The child has weak HIV-specific antibody and T cell responses. Furthermore, we determine his HLA and KIR genotypes. This case aids in understanding post-treatment control and may help design of future intervention strategies.

Suggested Citation

  • Avy Violari & Mark F. Cotton & Louise Kuhn & Diana B. Schramm & Maria Paximadis & Shayne Loubser & Sharon Shalekoff & Bianca Da Costa Dias & Kennedy Otwombe & Afaaf Liberty & James McIntyre & Abdel Ba, 2019. "A child with perinatal HIV infection and long-term sustained virological control following antiretroviral treatment cessation," Nature Communications, Nature, vol. 10(1), pages 1-11, December.
    • Handle: RePEc:nat:natcom:v:10:y:2019:i:1:d:10.1038_s41467-019-08311-0
    DOI: 10.1038/s41467-019-08311-0
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    Cited by:

    1. Xiaolei Wang & Eunice Vincent & Summer Siddiqui & Katherine Turnbull & Hong Lu & Robert Blair & Xueling Wu & Meagan Watkins & Widade Ziani & Jiasheng Shao & Lara A. Doyle-Meyers & Kasi E. Russell-Lodr, 2022. "Early treatment regimens achieve sustained virologic remission in infant macaques infected with SIV at birth," Nature Communications, Nature, vol. 13(1), pages 1-12, December.

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