Advances in treatment
Since the first cases of AIDS appeared in 1981, more than 30 antiretroviral drugs and combination therapies have been approved by the regulatory authorities. There is evidence that shows that approved antiretroviral drugs interfere with HIV’s replication cycle.
In addition, recently the European regulatory authority EMA approved lenacapavir, the most advanced HIV capsid binding inhibitor. Sunlenca | European Medicines Agency (europa.eu)
The availability of different drugs has turned HIV-1 infection into a chronic, but manageable disease.
Better access to therapy
As per the UNAIDS Global AIDS Update 2022, 76% of adults (aged ≥15 years) with HIV had access to antiretroviral therapy (ART) in 2021.
The benefit of initiating ART early
Numerous studies, conducted by several scientists including EPIICAL investigators, have shown a benefit from early initiation of antiretroviral therapy (ART). In particular starting ART immediately after birth and diagnosis is associated with:
- better survival
- reduction in viral reservoir size
- improvement of the immune response
- normal development of neurological system.
In few reported cases, children have been able to control the virus and live well long after they quit HIV medications.
The “Mississippi Baby,” born with HIV in 2010, received anti-HIV treatment beginning 30 hours after birth, stopped therapy around 18 months of age, and controlled the virus without drugs for 27 months before it reappeared in her blood.
In 2015, researchers reported that a French child who was born with HIV in 1996, started anti-HIV therapy at age 3 months, and stopped treatment sometime between ages 5.5 and 7 years continued to control the virus without drugs more than 11 years later.
Scientists reported in 2017 that, one child enrolled in the CHER trial who received anti-HIV treatment during infancy suppressed the virus without anti-HIV drugs for eight and a half years.
These unusual cases reinforce the hope of developing strategies to achieve a prolonged ART-free remission in early-treated children.