A View from Susan Young Rojahn
A Toddler May Have Been Cured of HIV Infection
An accidental discovery in pediatric HIV treatment may one day save others born into infection.
Scientists with the National Institutes of Health announced on Sunday that a two-year-old child infected with HIV at birth had no signs of active virus despite being off anti-retroviral medication for nearly a year.
The baby, born in rural Mississippi, was treated aggressively with antiretroviral drugs starting around 30 hours after birth, something that is not usually done.
Typically a newborn with an infected mother would be given one or two drugs as a prophylactic measure. But Dr. Gay said that based on her experience, she almost immediately used a three-drug regimen aimed at treatment, not prophylaxis, not even waiting for the test results confirming infection.
The toddler is the second person to have been “functionally cured,” meaning that the child may be able to safely remain off of anti-HIV drugs even though trace amounts of the virus can be detected in her blood. The first person was the “Berlin Patient,” a man infected with HIV who received a stem-cell transplant to treat another disease (see “Bone Marrow Transplant Appears to Halt HIV”). The risky transplant procedure replaced his immune cells with immune cells from a donor who carried a genetic mutation that prevents HIV infection.
Like the Berlin Patient, the Mississippi toddler is a special cases and it may be that there is something unique about the still-developing immune systems of infants that enabled the potential cure. Researchers continue to pursue treatments such as genetically modifying immune stem cells for a more broadly applicable cure (see “Can AIDS Be Cured?”).
Still, as reported by the Los Angeles Times, the discovery offers hope for other infected infants:
If researchers demonstrate that the same treatment can work in other children, it could drastically alter the lives of the estimated 1,000 babies born with HIV every day, most of them in Africa, doctors said.
Attempting to replicate the results in other HIV-positive infants is “our next step,” said Dr. Deborah Persaud, a virologist at Johns Hopkins Children’s Center who described the Mississippi patient at the Conference on Retroviruses and Opportunistic Infections.