Promising HIV cure could be achieved through children: Decade long tests reveal
New evidence from global HIV research suggests that the first widespread cure for HIV may be possible in children who receive antiretroviral therapy (ART) early in life. Pediatrician and immunologist Philip Goulder from the University of Oxford, working with researchers in South Africa, found that a small subset of HIV-infected infants treated soon after birth can suppress the virus to undetectable levels and maintain remission without ongoing medication for extended periods.
After tracking several hundred children infected through mother-to-child transmission, Goulder's team was astonished to find five children who had stopped ART yet showed no viral rebound even after months off medicine, defying the typical two to three weeks it takes for HIV to return when treatment is interrupted. One child maintained remission for an unprecedented 17 months. These children's immune systems appear uniquely capable of controlling HIV independently, a phenomenon not seen in adults despite decades of research.
According to Alfredo Tagarro, a pediatrician at the Infanta Sofia University Hospital in Madrid, children living with HIV have often been overlooked in the effort to develop treatments that can achieve permanent remission.
Since 2007, about 10 adults are believed to have been cured of HIV through stem cell transplants intended to treat life-threatening blood cancers. While these procedures successfully eradicated the virus, their complexity and significant risks—including several patient deaths—make them an impractical approach for targeting HIV specifically. At the 2025 International AIDS Society conference in Kigali, additional data showed approximately 5% of HIV-positive children initiating ART within six months of birth could reduce the viral reservoir—genetic material of the virus hidden in cells—to negligible levels. Pediatric experts attribute children's more dynamic immune systems and fewer health complications as factors that may enable this early cure. Mark Cotton of the University of Stellenbosch emphasized children's suitability for curative therapies compared to adults with comorbidities.
Building on these insights, Goulder has launched a new study involving 19 South African children who have suppressed HIV reservoirs under ART. He plans to carefully discontinue treatment and monitor how many keep the virus suppressed long-term. Early results show six children maintaining remission for more than 18 months without drugs. Boys may have an immunological advantage in controlling HIV due to innate immune system differences.Cutting-edge experimental treatments are also being explored in children, including gene therapy designed to make muscle cells continuously produce broadly neutralizing antibodies (bNAbs). This one-time therapy could protect infants in high-prevalence regions by preventing HIV transmission from birth or breastfeeding. Research in newborn monkeys highlights a critical early window post-birth when gene therapy is most effective, potentially revolutionizing pediatric HIV care in resource-limited settings.Despite recent funding setbacks, researchers remain optimistic. Combining ART with bNAbs, vaccines, and gene therapies may jointly corner and eliminate the virus, similar to successful pediatric leukemia treatments. While children represent a minority of global HIV cases, a cure in this group could provide the blueprint for universal HIV eradication strategies.The global impact could be profound: about 1.7 million children worldwide live with HIV, many in low-income countries where lifelong ART adherence is challenging. An effective cure would drastically reduce the health and social burdens of pediatric HIV and pave the way for transforming HIV from a chronic condition into a curable disease.This breakthrough marks a historic turning point in the decades-long fight against HIV, with children potentially leading the route to a cure and offering hope for millions affected worldwide.
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