U.S. baby's HIV infection cured through very early treatment; Mississippi case is first account of an infant HIV cure.
JACKSON, MISSISSIPPI, UNITED STATES (MARCH 3, 2013) (NBC) - A baby girl in Mississippi who was born with HIV has been cured after very early treatment with standard HIV drugs, U.S. researchers reported on Sunday (March 3), in a potentially ground-breaking case that could offer insights on how to eradicate HIV infection in its youngest victims.
The child's story is the first account of an infant achieving a so-called functional cure, a rare event in which a person achieves remission without the need for drugs and standard blood tests show no signs that the virus is making copies of itself.
More testing needs to be done to see if the treatment would have the same effect on other children, but the results could change the way high-risk babies are treated and possibly lead to a cure for children with HIV, the virus that causes AIDS.
"At last follow up we've been unable to detect replication-competent virus at 10 months off of anti-retroviral therapy. And the child remains off of anti-retroviral therapy and is doing well," said Dr. Deborah Persaud, a virologist at Johns Hopkins University in Baltimore, who presented the findings at the Conference on Retroviruses and Opportunistic Infections in Atlanta.
The child's story is different from the now famous case of Timothy Ray Brown, the so-called "Berlinpatient," whose HIV infection was completely eradicated through an elaborate treatment for leukemia in 2007 that involved the destruction of his immune system and a stem cell transplant from a donor with a rare genetic mutation that resists HIV infection.
Instead of Brown's costly treatment, however, the case of the Mississippi baby, who was not identified, involved the use of a cocktail of widely available drugs already used to treat HIV infection in infants.
When the baby girl was born in a rural hospital in July 2010, her mother had just tested positive for HIVinfection. Because her mother had not received any prenatal HIV treatment, doctors knew the child was at high risk of infection. They transferred her to the University of Mississippi Medical Center in Jackson, where she came under the care of Dr. Hannah Gay, a pediatric HIV specialist.
Because of her risk, Dr. Gay put the infant on a cocktail of three HIV-fighting drugs - zidovudine (also known as AZT), lamivudine, and nevirapine - when she was just 30 hours old. Two blood tests done within the first 48 hours of the child's life confirmed her infection and she was kept on the full treatment regimen, Persaud told reporters at the conference.
In more typical pregnancies, when an HIV-infected mother has been given drugs to reduce the risk of transmission to her child, the baby would only have been given a single drug, nevirapine.
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 rekindleHIV infection in patients who stop therapy, and they are the reason most HIV-infected individuals need lifelong treatment to keep the infection at bay.