March 4, 2013 8:18 am
Worldwide, 42 million people live with HIV. Every year, five million are infected, and 800,000 of those new infections are children. But children who are born with or contract HIV at a young age, the condition might no longer be a death sentence. Researchers at Johns Hopkins University say they have cured a baby of HIV using standard HIV drugs very early in life.
The baby was born to an HIV-positive mother, and within 30 hours of birth was placed on a full treatment regimen of three HIV-drugs. Reuters writes:
Researchers believe use of the more aggressive antiretroviral treatment when the child was just days old likely resulted in her cure by keeping the virus from forming hard-to-treat pools of cells known as viral reservoirs, which lie dormant and out of the reach of standard medications. These reservoirs rekindle HIV infection in patients who stop therapy, and they are the reason most HIV-infected individuals need lifelong treatment to keep the infection at bay.
After starting on treatment, the baby’s immune system responded and tests showed diminishing levels of the virus until it was undetectable 29 days after birth. Ten months later, when the baby returned to the hospital (her mother stopped bringing her, without explanation) the researchers tested her again for HIV and found no sign of the virus. It appeared she had been functionally cured.
Of course, a cure for HIV is a huge claim, and some outside researchers are still waiting for more information before they celebrate. The New York Times writes:
Some outside experts, who have not yet heard all the details, said they needed convincing that the baby had truly been infected. If not, this would be a case of prevention, something already done for babies born to infected mothers.
“The one uncertainty is really definitive evidence that the child was indeed infected,” said Dr. Daniel R. Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital in Boston.
And, in fact, the researchers had that same thought. Hannah Gay, the disease specialist who thought of treating the baby with the drugs in the first place, said that when the child tested negative after ten months without treatment, that was her first thought too. She told NPR:
“My first thought was, ‘Oh my goodness, I’ve been treating a child who’s not actually infected,’ ” Gay says. But a look at the earlier blood work confirmed the child had been infected with HIV at birth. So Gay then thought the lab must have made a mistake with the new blood samples. So she ran those tests again.
This time, they ran a more sensitive test. What they found was pieces of the HIV DNA and RNA, proving that it had been there, but no signs that the virus was active and replicating within the child. This is what many people are calling a “functional cure.”
Obviously, everyone wants more tests and more research. And the doctors in this case were quick to warn parents of children being treated for HIV not to take their children off the medications. Here’s Reuters again:
But the doctors warned parents not to be tempted to take their children off treatment to see if the virus comes back. Normally, when patients stop taking their medications, the virus comes roaring back, and treatment interruptions increase the risk that the virus will develop drug resistance.
“We don’t want that,” Dr. Gay said. “Patients who are on successful therapy need to stay on their successful therapy until we figure out a whole lot more about what was going on with this child and what we can do for others in the future.”
A big difference between this Mississippi baby and the famous Berlin patient—a man who was seemingly cured of HIV through a bone transplant—is that the baby’s treatment is far more accessible. Here’s NPR again:
The only other such case known to AIDS researchers is the so-called Berlin patient – a San Francisco man named Timothy Brown. But his treatment involved a bone marrow transplant in Germany – essentially, he was given the immune system of a donor who’s genetically resistant to HIV. That’s not something that can be easily duplicated.
If this patient proves to be truly cured, it involves drugs that could be administered to the nearly 1,000 newborns born with HIV each day.
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