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Novel therapies/hopes for HIV cure in perinatally acquired HIV-positive adolescents

Pasvol, TJ; Foster, C; Fidler, S; (2018) Novel therapies/hopes for HIV cure in perinatally acquired HIV-positive adolescents. Current Opinion in HIV and AIDS , 13 (3) pp. 281-287. 10.1097/COH.0000000000000455. Green open access

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Abstract

Purpose of review: Successful roll-out of paediatric antiretroviral therapy (ART) has led to a significant increase in survival of adolescents and young people growing up with HIV. Those on suppressive ART since childhood represent a unique group particularly well positioned to interrupt ART and achieve post-treatment control (PTC), or HIV remission. This maybe a consequence of early and sustained treatment since infancy, the small size of the HIV reservoir, the presence of a functioning thymus and a more ‘flexible’ immune system better able to respond to novel immune therapeutic interventions when compared with adults who acquired HIV at a time of immunological maturity and thymic involution. / Recent findings: In the past year, there have been additional case reports of post-treatment viral control amongst perinatally acquired HIV adolescents and young adults (PaHIV-AYA). In this article, we review and compare the characteristics of PTC in PaHIV-AYA and discuss the potential implications of these observations for the growing population of adolescents living with HIV. The correlation between low levels of HIV DNA and seroreversion may provide a feasible screening tool to select candidates most suitable for future intervention studies and viral remission. / Conclusion: Whilst it is premature to anticipate an HIV cure, there is much anticipation that with early ART and additional interventions to perturb the residual viral reservoir, future viral remission off ART might be feasible for PaHIV-AYA. However, given the safety and effectiveness of current ART, a critical debate must evaluate the risks against benefits of any novel intervention, especially amongst adolescents as they become sexually active.

Type: Article
Title: Novel therapies/hopes for HIV cure in perinatally acquired HIV-positive adolescents
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/COH.0000000000000455
Publisher version: https://journals.lww.com/co-hivandaids/Abstract/20...
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: HIV remission, perinatal HIV infection, post-treatment control
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10059342
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