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Early antiretroviral treatment reduces viral reservoirs in HIV-infected teens




 



2013 MAR 18 (NewsRx) -- By a News Reporter-Staff News Editor at AIDS Weekly -- A study led by University of Massachusetts Medical School professor and immunologist Katherine Luzuriaga, MD, and Johns Hopkins Children's Center virologist Deborah Persaud, MD, highlights the long-term benefits of early antiretroviral therapy (ART) initiated in infants.

The study, presented on March 4 at the 20th annual Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta, shows that ART administered in early infancy can help curtail the formation of hard-to-treat viral sanctuaries - reservoirs of "sleeper" cells responsible for reigniting infection in most HIV patients within weeks of stopping therapy.

The report describes nine teenagers, five of whom started ART around two months of age. Ultrasensitive testing showed dramatically lower copy numbers of viral DNA in the five teens who received ART within two months of exposure compared to the four teens who started treatment at a later age. In addition, serial testing demonstrated a small decay in the amounts of HIV DNA in the blood of the early-treated children over time. Moreover, using very sensitive techniques, the researchers were not able to recover HIV from the early-treated teens. In contrast, clinical tests detected viral hideouts in the late-treated teens. Four of the five early-treated children showed no HIV-specific antibodies on standard testing, but antibodies were detected in the blood of all four who started treatment late (see also HIV/AIDS).

In a related report, Dr. Luzuriaga and Dr. Persaud reported on March 3 the case of an infant who underwent remission of HIV infection after receiving ART within 30 hours of birth. Altogether, these findings, the researchers say, can help pave the way toward achieving long-term viral suppression without treatment in children. Long-term viral suppression without treatment is an exceedingly rare phenomenon observed in so-called "elite controllers," HIV-infected patients whose immune systems are able to rein in viral replication and keep the virus at clinically undetectable levels even without treatment. HIV experts have long sought a way to help all HIV patients achieve such elite-controller status.

"Preventing mother-to-child transmission remains our primary goal but these studies provide the impetus for further studies aimed at curing children if they do acquire infection," says Luzuriaga.

Luzuriaga, a professor of pediatrics and molecular medicine at UMass Medical School, has been investigating maternal-fetal transmission and pediatric HIV since the disease was first identified. Her laboratory focuses on the immunopathogenesis of persistent viral infections in humans, and the development of prophylactic and therapeutic vaccine strategies for HIV.

Keywords for this news article include: Antiretrovirals, Drugs, Therapy, HIV/AIDS, Virology, Pediatrics, RNA Viruses, Retroviridae, HIV Infections, Viral Vaccines, Vertebrate Viruses, Primate Lentiviruses, Acquired Immunodeficiency Syndrome, Viral Sexually Transmitted Diseases, University of Massachusetts Medical School.

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Information in this article was accurate in March 18, 2013. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.