What You Need to Know About the Teen Who Has Been in HIV Remission for 12 Years

New findings relating to a girl who was infected at birth with HIV but who has been in remission for the past 12 years without antiretroviral medication is sparking new interest in how HIV remission happens and what might be special about people who contract the virus but don’t display symptoms.

The girl, whose name has not been disclosed to the public, is a French national who contracted HIV at birth from her HIV-positive mother. Shortly after birth the girl was placed on antiretroviral therapy for six years. Her family then chose to stop treatment. Doctors continued to monitor the girl, and when she was tested a year later the doctors found that her viral load was still undetectable by standard HIV tests.

Of itself this is somewhat unusual but not unheard of. However the girl has gone untreated for the past 12 years now, with doctors monitoring her health to see if she would develop the disease. Her viral load has remained undetectable to standard tests, and the disease has not progressed.

These are the findings that researchers from the Institut Pasteur in Paris presented at the recent 8th International AIDS Society (IAS) Conference. Though the researchers are quick to say that this is not a cure–the girl is still considered HIV positive–they are keen to understand precisely how this remission has lasted for so long and why it happened in the first place.

Professor Jean-François Delfraissy, director of France’s National Agency for Research on AIDS, is quoted as saying: “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.”

We’ve previously documented isolated cases of people entering HIV remission after major medical interventions like bone marrow transplants, which have then led to the virus becoming virtually undetectable. Unfortunately, this kind of remission–once dubbed a functional cure–isn’t well understood and may not last as signs of the virus regrouping have later been detected. There’s also the fact that it is clearly impractical as a front line treatment for HIV that takes the shine off of these few instances of so-called functional cures.

In more general terms however, though still speaking in relatively few numbers, there is among people living with HIV a subset known as “elite controllers” who–in a way not yet fully understood–are able to become infected with the virus but do not go on to develop the symptoms associated with HIV. These elite controllers experience spontaneous remission that lasts for years, and previous studies have shown they appear to share common gene mutations, including one that increases the enzyme APOBEC, an enzyme that is usually depleted or inhibited by HIV but which for them stays robust, and in this way may stop the virus from replicating itself.

The researchers have not yet concluded whether the girl in question here has that gene or whether she has any other underlying genetic mutations that might account for her elite controller status.  The researchers are keen to emphasize however that this may also be due to the fact that the girl was able to receive treatment shortly after birth, potentially showing the success of antiretrovirals.

This is particularly interesting because of what it might mean for other children born with HIV. If the researchers’ notion that the girl’s remission is at least partly down to the antiretrovirals she received at birth, it certainly has scientific value because it supports the World Health Organization’s call for HIV treatment to begin as soon as possible after infection. It is also worth investigation because understanding what happened could open the door for giving certain patients an as yet undefined period of remission, which for young children could be particularly beneficial.

That said, we do routinely treat HIV-positive newborns when we are able, so it’s unlikely that the treatment alone was the factor that pushed the girl into remission or we would have hundreds if not thousands of children showing similar remission periods.

Finding what was the special ingredient in this case, and it’s likely to be a number of traits, will be key to understanding how we might facilitate remission windows and prolong a life free of the need for antiretroviral medication, something that is desirable because, even if that remission window lasts only a few years, it could improve future treatment prospects by lowering the chances of drug resistance, and on the whole improve quality of life for people living with HIV.

Photo credit: Thinkstock.

47 comments

Siyus Copetallus
Siyus Copetallus1 years ago

Thank you for sharing!

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Oliver Webb
Only Me2 years ago

This is a definite ray of hope.

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Vikram S.
Vikram S2 years ago

Thanks for sharing.

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ERIKA SOMLAI
ERIKA S2 years ago

thank you for sharing this

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D.E.A. C.
D.E.A. C2 years ago

Thanks for the additional information. Any and all hope is appreciated.

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Paulinha Russell
Paulinha Russell2 years ago

Thank you

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Karen H.
Karen H2 years ago

No sense chastising the spammers; they leave their crap and move on. They don't read our "shame on you" comments. I just keep flagging them.

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Heidi Werbrouck
Heidi W2 years ago

SPAMMERS SHAME ON YOU!!!!!!!!!!
What the hell do you think to achieve with your nonsens? Except for the retroviral meds NOTHING helps to push back HIV/AIDS. YOU SHOULD BE ASHAMED OF YOURSELVES YOU MORONS!

That said, I really hope this is a turn for the better, not only for this young woman but for anyone with HIV/AIDS.

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pam w.
pam w2 years ago

30 years ago....people were dying of AIDS every day. Now, medications and treatment therapies are saving many. Let's hope for the best.

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Fi T.
Past Member 2 years ago

What would our future be like?

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