Photo/FILE In 2009, Unicef estimated that 180,000 children aged between 0 and 14 years were living with HIV.
By ARTHUR OKWEMBA
Posted Friday, March 23 2012 at 20:31
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.
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.
Viramic controllers have an immune system that keeps the virus at very low levels.
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.
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.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.
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.
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