Infant first to be 'functionally cured' of HIV, researchers say
Published Sunday, March 3, 2013 4:36PM EST
Last Updated Monday, March 4, 2013 11:09PM EST
U.S. researchers say they have, for the first time ever, “functionally cured” an HIV-infected infant, a breakthrough that could one day end HIV infection in children.
The researchers -- from Johns Hopkins Children’s Center, the University of Mississippi Medical Center and the University of Massachusetts Medical School -- unveiled their ground-breaking research Sunday at the Conference on Retroviruses and Opportunistic Infections in Atlanta.
The team administered antiretroviral therapy to an infant born to an HIV-infected mother 30 hours after the child was born. The researchers say that in a series of tests afterward, the presence of the virus in the baby’s blood kept dropping until it hit undetectable levels 29 days after birth.
"I just felt like this baby was at higher-than-normal risk, and deserved our best shot," Dr. Hannah Gay, a pediatric HIV specialist at the University of Mississippi, said in an interview with The Associated Press.
The baby remained on antiretroviral therapy until 18 months of age, when researchers lost contact with the child and treatment was stopped.
Ten months later, researchers were able to conduct blood tests on the child, all of which indicated no viral presence. Tests for HIV-specific antibodies were also negative.
The researchers say the fact the child was treated so soon after birth likely stopped viral reservoirs from developing. These are dormant cells that re-start infection in the majority of HIV patients who stop antiretroviral therapy.
“Prompt antiviral therapy in newborns that begins within days of exposure may help infants clear the virus and achieve long-term remission without lifelong treatment by preventing such viral hideouts from forming in the first place," lead study author Dr. Deborah Persaud, a virologist at the Johns Hopkins Children’s Center, said in a statement.
The researchers say the child is now “functionally cured” of HIV, meaning the virus has gone into remission even though treatment was stopped, and standard clinical tests no longer detect HIV in the blood.
"You could call this about as close to a cure, if not a cure, that we've seen," said Dr. Anthony Fauci of the U.S. National Institutes of Health, which funded the research with the American Foundation for AIDS Research (Amfar).
However, Fauci warned that no one should stop taking antiretrovirals as a result of the findings.
The research could change the way newborns at high risk of HIV infection are treated. Currently, babies born to mothers whose HIV infection is poorly controlled or whose infection is only discovered near delivery are treated with a high dose of antiretrovirals for six weeks in an effort to prevent infection. The baby will be put on a regular dose of antivirals if HIV is detected in its blood.
The researchers caution, however, that further study is needed to confirm their findings in other high-risk newborns.
"Our next step is to find out if this is a highly unusual response to very early antiretroviral therapy or something we can actually replicate in other high-risk newborns," Persaud said in the statement.
Dr. Steven Deeks of the University of California, San Francisco, said that in light of the findings, researchers have reason to revisit other cases in which children were treated shortly after birth, including some reports of possible cures from the 1990s.
“This will likely inspire the field, make people more optimistic that this is possible,” he said.
Dr. Rowena Johnston of Amfar said the Mississippi case shows “there may be different cures for different populations of HIV-infected people.”
The researchers note that while finding an effective treatment for HIV-infected newborns is important, research focus should still remain on preventing mother-to-child infection.
With files from The Associated Press