Zimbabwe: Kicking HIV Out of Hibernation

Roselyne Sachiti

The Herald [Zimbabwe]

A follower of one of the many Pentecostal churches in Zimbabwe hops and runs as he makes his way to the podium. It is a cool Sunday afternoon in March 2014 and he stands in front of over 30 000 other followers to announce that he has been cured of HIV and has his latest results to prove it.

The man has been living with the disease for 11 years and attributes his cure to the powerful prayers from his pastor.

He has stopped taking antiretroviral drugs. But, a year later, the disease resurfaces. His faith was too weak, some people from his church tell him.

Not long afterwards, he dies.

Thousands of kilometres away, news that a baby from the United States, known as the Mississippi child, thought to be cured of HIV, had rebounded with detectable levels of the virus in her blood breaks.

The child was born to a mother who received no prenatal care and was not diagnosed as HIV positive herself until just before delivery. As such she missed out on the prevention of mother to child transmission intervention, which has saved lives of many babies the world over. In a frantic move to control the virus, doctors administered high doses of three antiretroviral drugs 30 hours after the girl was born, in case she was infected. At that time, the virus was not detectable but they had to protect the girl who remained on ARVs for about 18 months. For unknown reasons, her mother stopped taking her medication.

A few months later, doctors said there was no evidence of the little girl having HIV in her blood. The good news broke, the girl was the first child to be functionally cured of HIV.

A functional cure is when the presence of the virus is so small lifelong treatment is not necessary and standard clinical tests cannot detect the virus in the blood.

But at the beginning of July this year, bad news trickled in. Researchers explained the Mississippi infant remained virus free for 27 months as the cure was downgraded to remission. Thus, the issue of remission and fishing out HIV from the reservoir it hibernates in became one of the most talked about topics at the just ended 20th International Aids Conference in Melbourne, Australia. A top AIDS 2014 official and scientist Professor Sharon Lewin explained how latest research proved that HIV could hide in one single cell, making someone appear negative as in the Mississippi baby case.

She revealed how scientists also realised last year that the HIV virus can hang around for a long time and pop up at an unexpected time.

“This is what we found in the Mississippi baby. What we have learnt from that is we need better tools to measure virus while people are on treatment and once they stop. We need much better assays to know where that virus is hiding.

“The most recent cases of the Mississipi baby and the Boston patient who also rebounded after stopping treatment tell us that we should not only tackle the virus that persists on treatment but also need a good immune response ready to tackle any virus that emerges,” she added.

Prof Lewin added that their efforts for an HIV cure were currently on developing treatments leading to remission.

“Latest research and findings are significant in that they have shown us that we can wake up the virus reservoir and make enough of the virus to leave the cell, making it visible to an immune response.

 

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