Five minors who acquired HIV before birth and who, despite having stopped taking antiretroviral treatment, maintain the virus undetectable in their blood. The discovery, published in ‘Nature Medicine‘, is based on the follow-up of 284 newborns in South Africa, all treated from birth.
The study led by the Oxford Universitywith the collaboration of IrsiCaixahighlights that these five exceptional cases are due to the fact that the HIV present in their bodies has a lower capacity for replication and is more sensitive to the innate immune response, especially to interferon.
The team also observed differences between the sexes: although 60% of the newborns analyzed were girls, the five exceptional control cases were boys. These factors, along with other characteristics of the innate immune system, differ between males and females, which could explain why the five exceptional cases identified are from children.
The data suggest that, when antiretroviral treatment is started early after birth, some children can achieve spontaneous control of the virus, and that this control appears to be related to biological differences between the sexes.
According to Javier Martínez-Picadoresearcher at IrsiCaixa, understanding these mechanisms is key to the development of future HIV cure strategies.
This team had already seen, in a study published in ‘Nature Medicine’, that boys are born with a greater natural resistance to HIV compared to girls. This research pointed out that this disparity between genders is due to lower levels of activated CD4 T cells in male fetuses, which makes it difficult for the virus to survive. CD4 T cells are crucial to the immune system and are the target of HIV during infection. With lower counts of these cells, HIV spreads more slowly.
The study now suggests that viruses transmitted to male newborns are more sensitive to interferon, making it easier to control by the immune system.
Healing
This finding reinforces the need to address HIV cure strategies considering biological differences between sexes, in order to design more effective treatments for each group.
Currently, only 58% of children with HIV in the world have access to adequate antiretroviral treatment.
Findings like those in this study offer hope for the development of therapies that can take advantage of the advantages of the innate immune system to control the virus without the need for constant treatment, representing a significant advance in the fight to find a definitive cure for HIV in the child population.
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