Novel therapies/hopes for HIV cure in perinatally acquired HIV-positive adolescents.
File(s)
Author(s)
Pasvol, Thomas Joshua
Foster, Caroline
Fidler, Sarah
Type
Journal Article
Abstract
PURPOSE OF REVIEW: Successful roll-out of paediatric antiretroviral therapy (ART) has led to a significant increase in survival of adolescents and young people growing up with HIV. Those on suppressive ART since childhood represent a unique group particularly well positioned to interrupt ART and achieve post-treatment control (PTC), or HIV remission. This maybe a consequence of early and sustained treatment since infancy, the small size of the HIV reservoir, the presence of a functioning thymus and a more 'flexible' immune system better able to respond to novel immune therapeutic interventions when compared with adults who acquired HIV at a time of immunological maturity and thymic involution. RECENT FINDINGS: In the past year, there have been additional case reports of post-treatment viral control amongst perinatally acquired HIV adolescents and young adults (PaHIV-AYA). In this article, we review and compare the characteristics of PTC in PaHIV-AYA and discuss the potential implications of these observations for the growing population of adolescents living with HIV. The correlation between low levels of HIV DNA and seroreversion may provide a feasible screening tool to select candidates most suitable for future intervention studies and viral remission. CONCLUSION: Whilst it is premature to anticipate an HIV cure, there is much anticipation that with early ART and additional interventions to perturb the residual viral reservoir, future viral remission off ART might be feasible for PaHIV-AYA. However, given the safety and effectiveness of current ART, a critical debate must evaluate the risks against benefits of any novel intervention, especially amongst adolescents as they become sexually active.
Date Issued
2018-05-01
Date Acceptance
2018-05-01
Citation
Current Opinion in HIV and AIDS, 2018, 13 (3), pp.281-287
ISSN
1746-630X
Publisher
Wolters Kluwer Health, Inc
Start Page
281
End Page
287
Journal / Book Title
Current Opinion in HIV and AIDS
Volume
13
Issue
3
Copyright Statement
© 2018 Wolters Kluwer Health, Inc. All rights reserved. This is a non-final version of an article published in final form in Current Opinion in HIV and AIDS. 13(3):281–287 https://dx.doi.org/10.1097/COH.0000000000000455
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29547411
Grant Number
RDA02 79560
Subjects
1117 Public Health And Health Services
Virology
Publication Status
Published
Coverage Spatial
United States