Controlling HIV Without Antiretroviral Drugs

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An eight-year-old child in South Africa is infected with HIV but is not using antiretroviral drugs to treat it. She was given treatment starting at eight weeks old, but at 40 weeks old she was taken off the drugs. After eight and a half years, the virus remains at a low and manageable level within her body.

Most people living with HIV take drugs to keep it in check. Once the drugs are stopped, the virus begins taking over the body. Researchers believe that the earlier an individual starts treatment, the higher their chance of successful management without the use of long-term drugs.

Antiretroviral drugs are effective at keeping HIV under control, but the virus can lie dormant inside immune memory cells and reappear once the treatment stops. Researchers have made attempts at shrinking these reserves but to little avail.

However, treating people soon after their initial infection might reduce the amount of virus that is able to effectively hide. Even if complete elimination is not possible, the rate at which it is released might be low enough for the body to combat on its own.

John Frater, a clinical researcher at Oxford University, held his own controlled study that looked at 200 people that had begun early treatment. One group stopped treatment after 12 weeks and the other after 48 weeks. After one year, the virus was undetectable in four percent of the group that had stopped treatment after only 12 weeks and 14 percent of the group that had stopped treatment after 48 weeks. Frater is convinced that early treatment is a factor in remission.

Early treatment alone is not enough to cause long-term remission, as pointed out by Timothy Heinrich of the University of California, San Francisco. He described a patient who was infected with HIV and started treatment 10 days later. The treatment was administered for 34 months, after which the patient had almost no traceable amounts of the virus in his system. However, after 7.4 months without treatment, the virus rebounded.

Steven Deeks of UCSF believes that lasting remission may be achieved by using drugs early enough after infection to reduce the size of virus reserves in the body, but late enough to allow time for the body to develop an immune memory response.

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