March 08, 2024
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Key takeaways:
- Four children remained in HIV remission for over a year after their treatment was paused.
- ART had been initiated very early in each case — within 48 hours of birth.
DENVER — Four children born with HIV who initiated ART within 48 hours of delivery later remained in treatment-free remission for over a year after ART was paused, researchers reported.
The first reported case of treatment-free HIV remission in a child was announced at the Conference on Retroviruses and Opportunistic Infections (CROI) in 2014. The toddler, known as the “Mississippi baby,” later experienced a rebound in detectable HIV after 2 years without treatment.
The remission “was likely due to the very early drug treatment, which she received at 30 hours of age,” Deborah Persaud, MD, director of pediatric infectious diseases at the Johns Hopkins Children’s Center, said during a press conference at this year’s CROI.
Persaud was at the conference to present findings from a study of children who received very early ART, which was developed to see if the Mississippi baby case could be replicated.
For the study, Persaud and colleagues enrolled 54 infants who acquired HIV in-utero and initiated ART within 48 hours of birth. The infants received the study regimen for up to 294 weeks after birth.
The researchers identified six participants who maintained sustained virologic suppression from 48 weeks onward to about 1 year of age with no detectable HIV RNA, making them eligible for treatment interruption. The participants — four females and two males — all resided in sub-Saharan Africa.
One child made it 80 weeks with undetectable virus, then experienced rebound. Three others remain in remission after 48, 52 and 64 weeks, according to Persaud and colleagues. The other two who discontinued ART experienced rebound within 3 and 8 weeks.
“This study provides the proof of concept that very early treatment of neonates can enable ART-free remission,” Persaud said.
In a press release, National Institute of Allergy and Infectious Diseases Director Jeanne M. Marrazzo, MD, MPH, said the findings “are a beacon for future HIV remission science and underscore the indispensable roles of the global network of clinicians and study staff who implement pediatric HIV research with the utmost care.”
References:
Children surpass a year of HIV remission after treatment pause. https://www.nih.gov/news-events/news-releases/children-surpass-year-hiv-remission-after-treatment-pause. Published Mar. 6, 2024. Accessed Mar. 6, 2024.
Persaud D, et al. Abstract 184. Presented at: Conference on Retroviruses and Opportunistic Infections; March 3-6, 2024; Denver.
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Sources/Disclosures
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Source:
Persaud D, et al. Abstract 184. Presented at: Conference on Retroviruses and Opportunistic Infections; March 3-6, 2024; Denver.
Disclosures:
Marrazzo and Persaud report no relevant financial disclosures.
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