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Dr. Persaud's original paper showed sustained remission in "the Mississipi HIV-1-infected baby" following ART. One possibility for the result may have been that the mother transmitted long-term non-progressive disease to the child (see comment by Dr. De Maria in NEJM, Feb 2014). In the latest paper from Luzuriaga, Persaud et al, the group shows that early, effective combination antiretroviral therapy significantly limits proviral and and replication-competent HIV-1 and promotes continuous decay of viral reservoirs.
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Reduced viral reservoirs in HIV-infected youth following early cART: A long-term follow-up report by Luzuriaga et al.Zeena Nackerdien
Effects of Sustained Virologic Control in Early-Treated HIV-1- Infected Children
cART, combination anti-retroviral therapy; rep., replication1 Luzuriaga K, Tabak B, Garber M, Chen YH, et al. Reduced HIV Reservoirs After Early Treatment HIV-1 Proviral Reservoirs Decay Continously Under Sustained Virologic Control in Early-Treated HIV-1- Infected Children. The Journal of Infectious Diseases. 2014 (e-pub).
Long-term follow-up (up to 18 years)
4 infected youth who received ART during established infection
(6-14.7 y) also included
cART started between 2 & 11 weeks of age
Perinatally infected youth (aged 14-18)
CONCLUSIONSEarly, effective
cART from infancy significantly limits
circulating levels of proviral and rep.-
competent HIV-1 & promotes
continuous decay of viral
reservoirs
