Two weeks ago,  the announcement that a baby had been ‘€˜functionally cured’€™ of HIV disease with the use of very early antiretroviral therapy (ART)  caused great excitement at the start of the  Conference on Retroviruses and Opportunistic Infections (CROI 2013). Now a study from France has found 14 adult patients who also started a course of ART soon after infection, who subsequently stopped it, and have not had to re-start because they have largely ‘€“ and in eight cases completely ‘€“ maintained undetectable viral loads for at least four years after stopping therapy (the baby has, so far, only managed a year off therapy).

Furthermore, the researchers suggest that such cases are only not more common simply because, once having started ART, few people stop. They estimate that 15% of people with HIV, if ART is started within six months of HIV infection and maintained for at least a year, could subsequently become so-called ‘€œpost-treatment controllers’€.

Their estimate is a stark contrast to findings from  studies conducted between 1996 and 2000, soon after the introduction of highly active antiretroviral therapy, which found no evidence that people who began treatment in primary infection could control HIV after stopping treatment. The key difference between those studies, and the French patients described this week, is that earlier studies looked at HIV control in people who had only received treatment for 12 to 18 months. The French patients had been on treatment for an average of three years before stopping, and all started treatment within ten weeks of infection, compared to within six months in previous studies.

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