God, AIDS, Africa & HOPE

pensées of a Catholic priest

Signs of hope – remission without long-term treatment

At the recent conference of the International Aids Society in Paris it was a topic hotly discussed by academics, researchers and representatives of NGO’s:

A 9-year-old South African child diagnosed with HIV when he was 1 month old has been in HIV remission for 8½ years — without regular treatment. This is the first reported case of a child controlling their HIV infection without drugs in Africa and the third known case globally. The related research was conducted among others by Prof Dr Mark Cotton, board member of our HOPE Cape Town Association.

Soon after diagnosis, the child was placed on antiretroviral treatment, or ART, for 40 weeks, at which point treatment was stopped and the child’s health was monitored. Blood tests in late 2015 revealed the child is in HIV remission, meaning levels of the virus in the blood are undetectable using standard tests. Subsequent testing of samples dating back to the child’s infancy confirm remission was achieved soon after treatment was stopped. Treatment was paused as part of a larger research trial investigating the potential for early ART to decrease infant mortality and cut the need for lifelong treatment among newborns infected with HIV. “This is really very rare,” said Dr. Avy Violari, head of pediatric clinical trials at the Perinatal HIV Research Unit at the University of Witwatersrand in South Africa. Violari is the child’s doctor and presented the findings at the 9th International AIDS Society Conference on HIV Science in Paris

The child, not identified, was part of a study known as the Children with HIV Early Anti-retroviral Therapy, or CHER, trial, conducted in the years 2005 to 2011. More than 370 infants infected with HIV were randomly assigned to immediately receive ART for either 40 weeks or 96 weeks. A third group received no immediate treatment, but instead was looked after according to standard guidelines at the time. The CHER trial set out to investigate whether mortality rates could be reduced, but also whether earlier treatment could keep children healthy enough to enable them to come off treatment for certain periods. “We were hoping to make it a slower-progressing disease,” said Violari.

The study found mortality decreased by 76% and HIV disease progression reduced by 75% among the infants who received treatment immediately, for 40 or 96 weeks. The group receiving standard treatment saw an increase in mortality based on interim results, so that arm of the trial was stopped early. But virus levels in the 9-year-old case remained and remain undetectable. “The child is the only child showing remission,” said Violari. “We cannot see virus in the blood … we can see fragments of the virus in the cells,” she said, adding that these fragments appear not to be able to replicate, for now.

The South African child is the third reported case of long-term HIV remission in a child after early, limited treatment with antiretroviral drugs.

The first case was a Mississippi baby, a girl born in 2010, who received ART just 30 hours after birth until she was 18 months old, at which point HIV remission was achieved. The baby sustained remission for 27 months, until 2015, when she rebounded and the virus was found in her blood, crushing hopes that this approach could be the route to a “functional cure” for HIV. Next came the 2015 case of a French teenager, now 20, whose mother was HIV positive. The French child was given antiretroviral treatment soon after birth, stopped treatment at age 6 and has maintained undetectable levels of the virus in her blood since.

“We are delighted and excited by what happened with this child … we need to extrapolate from this to the benefit of other children on antiretroviral drugs,” said Prof Mark Cotton, Professor of Pediatrics at Stellenbosch University in South Africa, who co-led the study. “Africa is still the epicenter of the epidemic and more babies are acquiring HIV than anywhere else.”

Cotton hopes his team presenting these results will boost morale, both among cure researchers and those managing treatment programs for children across the continent.

More links:

Hope for future HIV cure revived
It is really very rare
Without drugs

Filed under: Africa, HIV and AIDS, HIV Treatment, HOPE Cape Town Association, HOPE Cape Town Association & Trust, Medical and Research, South Africa, , , , , , , , , , , , , , , ,

World Aids Day

World Aids Day – once in a year the world is obliged to think about HIV and AIDS and all those being infected and affected. When traveling in Europe I mostly encounter a sort of fatigue or ignorance towards the topic. It seems that HIV does not posses any treat anymore, opposite to Ebola which seems to be more threatening and dangerous than any other disease or syndrome. Gays, drug users and prostitutes/escorts – those are the main focus groups so they say and again we are back within the circle having to deal with those at the margins of society. If it would be only that easy: I guess that most of the 34 million people living with HIV are not part of one of these groups – and looking to South Africa, it is indeed women carrying the heaviest burden of the pandemic. Let’s be honest: the talk about healing, about the possibility of healing just around the corner waiting to be discovered soon has added to the perception that all is fine now. Having potent medication, even Truvada as a precautionary remedy – at least for those who can afford them – is another factor fueling the feeling of safety and relive.

From a South African point of view things are different: HIV remains a treat to humanity and the war has not been won yet. The opposite is true: the false feeling of victory has given rise to a relaxation of attention and donations and support are dwindling. It looks to me that all efforts have let to the possibility of turning the tide, only to stop  short before achieving it and falling in back in the mental trap or wishful thinking that having done so much should be sufficient. Hundreds of new infections per day are talking a different language in the country I am living in. And the menace of resistance even calls louder for attention than ever before. We also thought that the Mississippi Baby, treated early would show a success in treatment, only to turn out a failure. Vaccine trials didn’t achieved what we have hoped for and looking into the development of medication – there is not that much new on the horizon, rather combinations or different forms of intake.

The war is not over yet and HIV is not defeated – the goals of the world for 2015 are not achieved and we now hope for 2025 or 2030, pushing the finishing line even further away. I am not sure most people have heard or noticed how fast a Hepatitis C cure was found – and how fast the Ebola trials are moving. Most HIV cases are Sub-Saharan and it seems that this area and it’s people are not worth a more pushy effort to find a cure. It sounds sarcastic but the threat of a resistant heterosexual virus hitting the global village might be the only argument to get those who have forgotten about the danger and feeling save to engage again more actively and turn the tide and achieve zero new infections in the real sense of the word beyond the World Aids Day and some festive events during the year.

For war, oil, fight over resources, terrorism and so-called terrorism billions of Euros and Dollars are spent with ease – why not for the end of the suffering of 34 million people?

 

 

Filed under: General, HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, Politics and Society, Reflection, Society and living environment, , , , , , , , , ,

No time to rest in the fight against HIV and AIDS

Coming back from Europe and heading next week to the World Aids Conference in Melbourne, the news about the so-called “Mississippi Baby” feels like a punch in the gut and a damper to the hopes of a functional cure. The child known as the “Mississippi baby” — whose apparent cure was reported in The New England Journal of Medicine last fall — has had the virus return after more than two years off anti-retroviral therapy, according to specialists involved in the case who spoke in a Thursday news briefing. “Certainly, this is a disappointing turn of events for this young child, the medical staff involved in the child’s care and the HIV/AIDS research community,” said Anthony Fauci, director of the National Institute of Allergy and Infection Diseases (USA), at the briefing. The development “reminds us that we still have much more to learn about the intricacies of HIV infection and where the virus hides in the body,” Fauci said in a statement. “The NIH remains committed to moving forward with research on a cure for HIV infection.”
Not only the NIH, but we all, the activists, researchers and those infected and affected have to acknowledge how bumpy the road to a functional cure or even a vaccine will be. This story ones again reminds us that HIV and Aids are not defeated yet. The easiness of European youth and society in believing that some pills would sort out those being infected – and further believing that this anyhow only applies to those others, those being gay or immigrants from Africa or injecting drug users should be re-evaluated after such news. HIV and Aids are still a treat to humanity and society and as we make progress, we can’t declare victory. Otherwise we look as stupid as then-president Bush declaring victory over Iraq on one of his war ships – look at the situation in the country in our days.
The news about the Mississippi baby should also serve as a warning to donors that withdrawing funding because we have won the battle is an illusion. The Global Aids Fund and all the NGO’s in the field of HIV, Aids and related illnesses need more funding to gain progress in the fight against the syndrome. We have achieved so much but there are still millions dying every year as a result of the pandemic and there are millions out there without treatment. Resistance is growing and we only have to look at TB and South Africa to see what could develop if we not keep watch. The virus is waiting for a re-run if society is not taking it serious anymore. And the dream of a HIV free generation will be blown up in shatters – therefore no time to rest in the fight against HIV and Aids.

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, Politics and Society, Reflection, , , , , , , , , , , , , , , , , , , , , , , ,

From lesbian sex and HVI transmission to the banning of the Red Cross in Catholic Schools- interesting read in between

Going to the high volumes of articles and journals in the field of HIV and AIDS I thought the following could be interesting for you:

Lesbian sex is thought to be the most safe one, but there is a fresh report from Houston in Texas confirming a rare female to female transmission of HIV. It is further reported that this transmission took place between two women in a monogamous relationship. All details of the story are published in “Morbidity and Mortality Weekly Report” – published 14.03.2014. To read a summary please click here

From the Mississippi Baby to the California Baby – we meanwhile know about the benefits of early treatment and the possibility of HIV eradication if treated within the first hours of infection.  Read more on this topic from the 21st Conference on Retroviruses and Opportunistic Infections here

From the CROI Conference as well there are new about safer sex without condom. Ever since the HPTN Study 052, it was concluded that having an undetectable HIV viral load strongly reduces the risk of HIV transmission. But how safe is condom-less sex if one’s viral load is undetectable? Read about the ongoing PARTNER study here

Hepatitis C – a short while ago a disaster for every person being HIV  has become a center of attention after treatment and cure evolved in a speedy way. The first medications have been retired shortly after introduction to make place for more effective treatment. Read about this exciting and important development here

HIV controllers were always an interesting study group. It was thought that those people could control HIV and were protected from getting sick. New research shows that the situation is more complicated and that such people have higher level of chronic inflammation. An interview with Jonathan Li, MD researching in this field might be giving interesting clues about the benefits and treats for those being naturally controlling HIV and you can read it here

Manila on the Philippines shows quite a rise on HIV infections and obviously the city responsible are trying to reign in with prevention messages and the free distribution of condoms. The dominant Roman-Catholic Church  condemns in the person of Auxiliary Bishop Broderick Pabillo this contribution and he calls to follow the example of Africa – where in his opinion only abstinence and fidelity has brought the numbers down. Read more about this interesting point of  view here

The Catholic Church in Belize has banned the Belize Red Cross amongst other organizations from all 200 Catholic Schools in the country. To read the response of the Red Cross click here

Filed under: Catholic Church, General, HIV and AIDS, HIV Prevention, HIV Treatment, Medical and Research, Politics and Society, Reflection, Religion and Ethics, Society and living environment, Uncategorized, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

14th HOPE Gala Dresden

HOPE Gala Dresden - the event to be in DresdenNovember 16th, 2019
31 days to go.

Ball of HOPE 2020

Join us @ The Westin in Cape TownMay 23rd, 2020
7 months to go.
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