Title

Very early combination antiretroviral therapy in infants: prospects for cure

UMMS Affiliation

Department of Pediatrics, Division of Immunology/Infectious Disease

Date

1-1-2015

Document Type

Article

Disciplines

Immunology and Infectious Disease | Infectious Disease | Pediatrics | Virus Diseases

Abstract

PURPOSE OF REVIEW: A single case of sustained HIV control in the absence of antiretroviral therapy or HIV-specific immune responses ensued following 18 months of combination antiretroviral therapy initiated at 30 h of age in a perinatally HIV-infected child (the Mississippi child). This case provides proof-of-concept that delay in HIV viremic rebound may ensue following very early treatment (VET) in perinatal infection, likely through marked reduction of latent replication-competent HIV reservoirs.

RECENT FINDINGS: The latent HIV reservoir remains the critical barrier to remission. Several studies indicate that the earlier effective combination antiretroviral therapy is initiated, the smaller the size of the HIV reservoir. The unique ability of perinatally infected neonates to initiate VET at the time of birth maximizes the potential benefits of limiting latent reservoir size and permitting reservoir decay, likely lengthening the duration of remission and limiting the capacity for re-establishment of viremia.

SUMMARY: This article covers the rationale and feasibility of VET to achieve sustained virologic remission in perinatal infection. Recent studies highlighting the effects of VET on biomarkers of HIV persistence in perinatal HIV infection are reviewed as well as implications and challenges for cure research in pediatric populations.

Rights and Permissions

Citation: Curr Opin HIV AIDS. 2015 Jan;10(1):4-11. doi: 10.1097/COH.0000000000000127. Link to article on publisher's site

Related Resources

Link to Article in PubMed

PubMed ID

25402708