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Scientists Report a Rare Case of H.I.V. Remission

For the third time in recent years, a child born with H.I.V. has been found free of the virus for a long period after a high dose of treatment early in life.

The discovery has raised anew the hope that early treatment, in some cases, may allow an infected person’s immune system to defeat the virus. But proof has remained elusive, and there have been more disappointments than triumphs.

The child — a 9-year-old South African girl — has been in remission for over eight years, according to research presented Monday at an International AIDS Society conference in Paris.

The case “strengthens our hope that by treating HIV-infected children for a brief period beginning in infancy, we may be able to spare them the burden of lifelong therapy,” Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said in a description of the case released by the institute, which sponsored a clinical trial in which the child was enrolled.

More research was still needed, he added.

The girl, born infected with H.I.V. in 2007, was put on antiretroviral treatment at nine weeks of age; then, as part of the trial, she was one of 143 children whose treatment was temporarily stopped at 40 weeks.

While other children saw their viral loads rebound, the girl still has no detectable H.I.V. in her blood, researchers said. But a reservoir of virus was found in a few immune cells, although none of it was deemed capable of replicating, they said.

Hope that early treatment could suppress H.I.V. indefinitely was first raised in 2013 in what became known as the “Mississippi baby” case, in which a young girl was apparently virus-free for two years after early aggressive treatment.

The girl, born prematurely to an H.I.V.-infected mother in 2010, was put on antiretroviral triple-therapy shortly after birth and stayed on it for 18 months, until her mother abruptly stopped taking her to doctors.

Months later, when the child was back in medical care, no virus could be found. Doctors speculated that it had been killed before it could establish a reservoir and made plans for a clinical trial by putting 450 babies on similar early treatment.

In 2014, however, the child’s viral load shot up, and treatment had to be restarted.

Another case was described at an AIDS conference in Vancouver in 2015. A French girl born in 1996 was quickly treated for six weeks with a drug meant to stop the infection from taking hold.

That failed, but she was then put a four-drug antiretroviral regimen for six years. At age 6, treatment was stopped, and researchers said she was still virus-free 11 years later.

Doctors do not know if the three children had any unusual genetic factors.

None had the rare mutation, known as delta 32, that produces immune system cells lacking the receptors to which H.I.V. attaches. People with it, sometimes known as “elite controllers,” can be repeatedly exposed to H.I.V. without getting infected.

The only person apparently cured of H.I.V. is Timothy Ray Brown, the “Berlin patient.”

In 2007, after he developed leukemia in addition to his H.I.V., doctors destroyed Brown’s immune system with radiation and chemotherapy and replaced it through a bone-marrow transplant from an elite controller. His H.I.V. infection has not returned.

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