An international study identified the case of five infants with controlled HIV without antiretroviral treatment.

A international research under the leadership Oxford Universityand with the participation of IrsiCaixa identified the case five children who acquired HIV before birthoh that they demonstrated exceptional control of the virus without antiretroviral treatment. The study involved 284 South African infants who were infected with the virus before birth but were on antiretroviral treatment from the start. The study results link these children’s ability to control HIV to having less replicative virus and greater sensitivity to interferon, which is a signature molecule of the immune response against HIV.

These factors, along with other characteristics of the innate immune system, differ between men and women. This bias may explain why the five outlier cases identified are male. Evidence suggests that when antiretroviral treatment is started early after birth, spontaneous viral control may be achieved in some children, and that this control may be associated with factors that differ by sex.

Healing Potential

In conclusion, rapid initiation of antiretroviral therapy, the absence of an overactivated immune system, and infection with a less aggressive virus are three factors that reduce the HIV reservoir and increase the likelihood of cure. ICREA researcher from IrsiCaixa Javier Martínez-Picado noted that these three factors are often found in children, making them an ideal scenario for implementing strategies to treat the virus.

Of the 284 infants included in the study, most managed to keep the virus undetectable in their blood thanks to antiretroviral treatment. By monitoring the levels of drugs present in the blood, it was possible to identify that in those who did not have a negative viral load, this was due to the fact that they were not taking treatment correctly. However, there were five cases in which, although the drugs were not detected in the blood or were detected in very low quantities, the virus was completely controlled.

The study results show that the virus obtained from the mother of the 5 HIV control cases had a lower replication capacity than that of the remaining children in the cohort. The researchers note that this fact, and the fact that the virus was sensitive to the immune response, may be two factors that help achieve such exceptional control.

Differences between the sexes

60% of the children tested were girls, but the five exceptional cases of control of the virus were boys. This prompted researchers to evaluate differences between both sexes. On the one hand, the study shows that viruses transmitted to male infants are more sensitive to interferon, a molecule that triggers an immune response against HIV. This makes the virus more susceptible to the body’s defenses and can be eliminated, making it easier to control if left untreated. On the other hand, viruses acquired by the male sex usually have a greater ability to replicate and therefore a greater ability to spread throughout the body. However, five exceptional cases deviated from this trend.

Martinez-Picado noted that the study shows that it is necessary to study HIV infection in children from the perspective of each gender separately. “This will allow us to more precisely understand how the infection works, establish candidate profiles for treatment strategies, and develop possible specific strategies for each sex,” he notes.

According to the latest UNAIDS report for 2022, there were approximately 130,000 new HIV infections among children under five years of age, most of them in low-income countries.