HIV-Infected and Untreated Children Do Not Develop AIDS

If Acquired Immune Deficiency Syndrome (AIDS) is a syndrome caused by virus Human Immunodeficiency Virus (HIV). Would it be possible that HIV-infected and untreated children do not develop AIDS? The new study  shows that this is possible for they control the virus in a different way from the few infected adults who remain disease-free, and sheds light on the reasons for this difference.

This new study is an international research collaboration led by Dr. Maximilian Muenchhoff at LMU's Max von Pettenkofer Institute and colleagues based at the University of Oxford (Professor Philip Goulder).

They studied the170 members of the cohort in Durban, South Africa. This cohort were infected with HIV by mother-to-child transmission. However, since these children showed no symptoms of a disease, the fact that they were infected was, in most cases, discovered only several years later when their mothers had developed AIDS and sought medical attention.

According to the report in the current issue of the journal Science Translational Medicine, "Children who are HIV-positive but remain free of AIDS are very rare. In the absence of antiretroviral therapy, over 99% of individuals infected with HIV go on to develop full-blown AIDS, and the condition evolves more rapidly in children than in adults. However, between 5 and 10% of perinatally infected HIV-positive children avoid this fate".

In the journal of Science Translational Medicine also reported "Although most people that get infected with HIV develop AIDS, rare individuals maintain immune function in the presence of the virus, a phenomenon also seen in natural hosts of the closely related SIV. Muenchhoff et al. describe a cohort of pediatric HIV patients who have normal CD4 T cell counts, despite high viremia and lack of antiviral treatment. These children have low immune activation, including less chemokine receptor CCR5 expression on central memory CD4 T cells, similar to sooty mangabeys infected with SIV. The immune mechanisms described in these patients shed light on HIV pathogenesis, which may help develop future treatments."

Professor Oliver T. Keppler, Chair of Virology at the Pettenkofer Institute, and former head of the German Reference Center for Retroviruses in Frankfurt am Main remarked  "This is a remarkable clinical study from the epicenter of the HIV pandemic. The ability of these children to maintain an intact immune system in the face of ongoing viral replication and in the absence of antiretroviral therapy can provide us with new insights into hitherto unknown defense mechanisms, which could eventually benefit other HIV patients".