Canadian study to probe early HIV treatment in infants as possible 'cure'
Published Friday, March 7, 2014 3:49PM EST
Last Updated Friday, March 7, 2014 11:26PM EST
A team of researchers say at least five Canadian children have been treated with an early, aggressive drug regimen that doctors south of the border have suggested could be a "cure" for HIV.
The Canadian scientists revealed Friday that an aggressive approach in the treatment of HIV in infants shortly after birth has been used in Canada for some time.
The scientists recently received nearly $2 million in funding from the Canadian Institutes of Health Research, the International AIDS Society and the Canadian Foundation for AIDS Research to study whether treating infants at risk of developing HIV immediately after birth leads to better health outcomes rather than waiting until the infection is confirmed to begin a drug regimen.
U.S. doctors revealed on Wednesday that a baby born with HIV in Los Angeles had the virus put into remission after beginning treatment hours after birth.
Last year, doctors claimed to have "cured" a Mississippi baby who was born with HIV after the infant was given high doses of three antiretroviral drugs just hours after delivery.
"We've been doing basically what they did in Mississippi here in Canada for some time," Dr. Jason Brophy, the study's co-principal investigator and researcher at the CHEO Research Institute in Ottawa, told CTV News.
Brophy said a review of some cases in Canadian children shows they have “as little HIV virus in their bodies” as was reported in the Los Angeles baby. They remained tight lipped about the full results, saying they will be presented at a Canadian AIDS meeting in March.
Brophy said the U.S. research has generated more interest in how aggressive HIV treatment shortly after birth affects the child's future health.
"It's very exciting," he said. "This is what everyone has wanted for a long time -- that maybe a cure for HIV would be possible in the future."
The researchers will be looking at about 200 Canadian cases where babies were treated for the HIV virus. Amongst those cases, they say at least five began treatment within 24 hours of birth and have continued treatment for a number of years.
In other cases, the HIV treatment was started months or years after birth, depending on when the HIV risk was identified. The question the doctors will be studying is which approach is best for beating back the virus, minimizing side effects of the medications, and to create what U.S. researchers have termed a “functional cure” with virus levels so low that they won’t trigger an active infection, or could lead to a complete remission from HIV infection altogether.
Dr. Ari Bitnun, the study's co-principal investigator and a pediatric AIDS specialist at the Hospital for Sick Children in Toronto, said what was unique in the Mississippi case is that the child came off HIV treatment, and once being re-engaged in care she still didn't have any detectable HIV virus in her blood.
"The key question in this scenario is, is there something about starting treatment very, very early , within the first day of life, is there something about that which can lead to a situation where we can't detect the virus later on after stopping the treatment," he said.
However Bitnun cautioned that there's "significant issues" with stopping HIV treatment.
"It isn't something that you do lightly because the virus can rebound."
He added that talk of an HIV "cure" is premature.
More importantly, he said HIV transmission from mother to child could be avoided all together if the mother is identified and put on treatment early in the pregnancy.
The study's project lead Hugo Soudeyns, a microbiologist at Montreal’s Sainte-Justine University Hospital Research Center said the aim of the study is to potentially end up with more effective HIV treatments in the future, "and perhaps eventually (HIV) management without medication."
"We need to really understand what is happening in these children, how the virus is controlled, where the virus remains in the body," Soudeyns said. "These are all very serious considerations that need to be taken into account before treatment interruption is being considered."
With a report from CTV's medical specialist Avis Favaro and producer Elizabeth St. Philip