Children Can Remain HIV-Free After Pause in Antiretroviral Therapy

WEDNESDAY, March 13, 2024 (HealthDay News) -- Very early treatment of in utero HIV-1 can result in antiretroviral therapy (ART)-free remission for ≥48 weeks, according to a study presented at the annual Conference on Retroviruses and Opportunistic Infections, held from March 3 to 6 in Denver.

Deborah Persaud, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues describe six children who received very early nevirapine- or protease inhibitor-based ART (initiation within 48 hours of birth) and underwent analytical treatment interruption (ATI) to assess for remission.

The researchers found that the children underwent ATI at a median of 5.5 years old. Four achieved study-defined remission (absence of replicating virus for ≥48 weeks off ART) one through 80 weeks of ATI, at which point viral rebound occurred. The other three remained in remission for 48, 52, and 64 weeks, respectively. Viral rebound occurred three and eight weeks after ATI in two children. Two children with rebound at 80 and eight weeks experienced mild acute retroviral syndrome; during or following ATI, there were no other clinical or immunological events of concern reported. The children with rebound at three or eight weeks had HIV RNA below the limit of detection at eight and 20 weeks after resumption of ART. Two weeks after resuming ART, the child with rebound at 80 weeks had HIV-1 RNA 724 cp/mL.

"These results are groundbreaking for HIV remission and cure research, and they also point to the necessity of immediate neonatal testing and treatment initiation in health care settings for all infants potentially exposed to HIV in utero," Persaud said in a statement.

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