Kenya: Why some children are living longer with the virus

[Guest guest]

Why some children are living longer with the virus

By ARTHUR OKWEMBA

Posted Friday, March 23 2012 at 20:31

A couple of years ago doctors said a child born with HIV had no chance of

surviving past the fifth birthday.

This was even more likely if the child was not on any anti-HIV treatment.

Those who beat the odds without treatment were considered miracle cases.

In 2009, Unicef estimated that 180,000 children aged between 0 and 14 years were

living with HIV.

Most of them are still alive, with some having managed the virus without

treatment.

With these children living beyond 10 years and entering adolescence without

being on antiretroviral drugs, scientists have started to investigate the

reasons behind their survival.

Recent studies and doctors' accounts link this to two key factors; the immune

system of the child or the type of the virus contracted.

These two factors explain why one child will progress to Aids very fast and the

other slowly, taking more than 10 years to get Aids.

Families grapple with dark secret

Those who fall in the latter case have a viral load of less than 50 copies and a

normal CD4 count — immune cells used to fight infections.

Just like in adults

Such children can either be elite controllers or viramic controllers. Elite

controllers are those whose antibodies are able to neutralise the virus.

Although this phenomenon is observed more in adults, doctors like Prof Omu

Anzala say it is also happening in children but at a lesser frequency.

Studies in adult elite controllers have shown them to possess high CD4 count and

very low viral loads (amount of HIV in the body), which are uncharacteristic of

an infected person.

They are also able to delay progression to Aids, the last stage of the disease

where opportunistic infections strike, killing the individual if not managed

well.

Prof Anzala, who is leading a study on the elite controllers at Kenya Aids

Vaccine Initiative, says some of the adults they have screened have antibodies

with a unique protein that targets specific sites of the virus, stopping it from

infecting new cells. He suspects the same in these children.

Scientists have in the past 10 years focused on elite controllers, believing

they hold the key to development of an effective anti-HIV vaccine.

Then there is genetic resistance. Scientists think some genetic traits confer

more robust immune responses towards HIV.

Apart from the host factors, medics suspect that the type of virus these

children have may explain why their longevity.

According to Surendra Patel, an adjunct professor at the University of Nairobi

College of Biological and Physical Sciences, some of these children might have a

weakened form of the HIV virus that replicates at an extremely slow rate.

Studies have shown individuals with certain subtypes of HIV-1 to be less likely

to progress towards Aids.

The legal dilemmas

Individuals with HIV subtypes C, D, and G are said to be eight times more likely

to progress to Aids than individuals infected with subtype A.

These subtypes are circulating in Kenya, with their distribution varying from

one region to another. While subtype A is dominant in the country, subtype G is

not.

There are also recombinant subtypes—when two HIV subtype join together in a body

cell to form a hybrid virus—such as AD, AE, AC and AG circulating in the

country.

Away from the scientific matters, children born with HIV have to confront legal

issues that define how their status can be disclosed to a third party.

The HIV and AIDS Prevention and Control Act of 2006 stipulates the circumstances

under which health officials can disclose the HIV status of a child, with the

written consent of a parent or legal guardian of that child.

These include where the child is engaged in behaviour which puts other persons

at risk of contracting HIV, is pregnant or is married.

http://www.nation.co.ke/News/Why+some+children+are+living+longer+with+the+virus+\

/-/1056/1372442/-/item/1/-/uu6hq5/-/index.html

[Guest guest]

Why some children are living longer with the virus

By ARTHUR OKWEMBA

Posted Friday, March 23 2012 at 20:31

A couple of years ago doctors said a child born with HIV had no chance of

surviving past the fifth birthday.

This was even more likely if the child was not on any anti-HIV treatment.

Those who beat the odds without treatment were considered miracle cases.

In 2009, Unicef estimated that 180,000 children aged between 0 and 14 years were

living with HIV.

Most of them are still alive, with some having managed the virus without

treatment.

With these children living beyond 10 years and entering adolescence without

being on antiretroviral drugs, scientists have started to investigate the

reasons behind their survival.

Recent studies and doctors' accounts link this to two key factors; the immune

system of the child or the type of the virus contracted.

These two factors explain why one child will progress to Aids very fast and the

other slowly, taking more than 10 years to get Aids.

Families grapple with dark secret

Those who fall in the latter case have a viral load of less than 50 copies and a

normal CD4 count — immune cells used to fight infections.

Just like in adults

Such children can either be elite controllers or viramic controllers. Elite

controllers are those whose antibodies are able to neutralise the virus.

Although this phenomenon is observed more in adults, doctors like Prof Omu

Anzala say it is also happening in children but at a lesser frequency.

Studies in adult elite controllers have shown them to possess high CD4 count and

very low viral loads (amount of HIV in the body), which are uncharacteristic of

an infected person.

They are also able to delay progression to Aids, the last stage of the disease

where opportunistic infections strike, killing the individual if not managed

well.

Prof Anzala, who is leading a study on the elite controllers at Kenya Aids

Vaccine Initiative, says some of the adults they have screened have antibodies

with a unique protein that targets specific sites of the virus, stopping it from

infecting new cells. He suspects the same in these children.

Scientists have in the past 10 years focused on elite controllers, believing

they hold the key to development of an effective anti-HIV vaccine.

Then there is genetic resistance. Scientists think some genetic traits confer

more robust immune responses towards HIV.

Apart from the host factors, medics suspect that the type of virus these

children have may explain why their longevity.

According to Surendra Patel, an adjunct professor at the University of Nairobi

College of Biological and Physical Sciences, some of these children might have a

weakened form of the HIV virus that replicates at an extremely slow rate.

Studies have shown individuals with certain subtypes of HIV-1 to be less likely

to progress towards Aids.

The legal dilemmas

Individuals with HIV subtypes C, D, and G are said to be eight times more likely

to progress to Aids than individuals infected with subtype A.

These subtypes are circulating in Kenya, with their distribution varying from

one region to another. While subtype A is dominant in the country, subtype G is

not.

There are also recombinant subtypes—when two HIV subtype join together in a body

cell to form a hybrid virus—such as AD, AE, AC and AG circulating in the

country.

Away from the scientific matters, children born with HIV have to confront legal

issues that define how their status can be disclosed to a third party.

The HIV and AIDS Prevention and Control Act of 2006 stipulates the circumstances

under which health officials can disclose the HIV status of a child, with the

written consent of a parent or legal guardian of that child.

These include where the child is engaged in behaviour which puts other persons

at risk of contracting HIV, is pregnant or is married.

http://www.nation.co.ke/News/Why+some+children+are+living+longer+with+the+virus+\

/-/1056/1372442/-/item/1/-/uu6hq5/-/index.html