A team of US doctors have made their mark on medical history by ‘functionally curing’ a toddler who was born with HIV, the virus that causes AIDs. At a conference on Retroviruses and Opportunistic Infections in Atlanta, Georgia, virologists described the case of a baby girl from Mississippi who is now two and a half years old and has been off medication for about a year with no signs of infection.
In this ground-breaking case, the baby was born to an HIV-positive mother who was unaware she had the virus until a standard test during her labour came back positive. Too late to administer any prenatal HIV treatment to prevent the mother passing the virus on to her child, doctors realised that the baby’s risk of infection was significantly higher than most cases. Just 30 hours after the baby’s birth, paediatric HIV specialist Dr. Hannah Gay put the child on an aggressive cocktail of three antiretroviral drugs, all of which are commonly used in the treatment of HIV-positive patients. Astonishingly, within a month of treatment, levels of HIV in the child’s blood were so low they were almost undetectable.
This treatment was continued for a year and a half, after which the mother and child stopped attending their clinic appointments. When doctors next saw the child, she was 23 months old and had not received any retroviral drugs for over five months. Tests were carried out to confirm the doctor’s predictions that the virus had returned, and yet, astonishingly, the results showed that it had not. Now, after a whole year without taking any medicine, the virus still has not returned.
Doctors are as yet unsure as to why the treatment was so effective, though it is thought that the combination of aggressive treatment and extremely early intervention may have eradicated HIV from the body before it could form ‘hideouts’ in the body’s white blood cells. In any case, the baby girl is now considered to be ‘functionally cured’, meaning that standard tests for the virus are negative, but it is likely that a tiny amount still remains in the body. Dr. Rowena Johnston, from the Foundation for Aids Research, said: “This certainly is the first documented case that we can truly believe from all the testing that has been done. Many doctors in six laboratories all applied different, very sophisticated tests trying to find HIV in this infant and nobody was able to find any. And so we really can quite confidently conclude at this point that the child does very much appear to be cured.”
At this point, it is impossible to say whether the virus will remain permanently in remission. Experts on the subject also noted that the same treatment would be ineffective in older children and adults, as the virus will already be too prominent and established in the body.
The case does suggest, however, that HIV can be potentially curable in infants, and cannot be denied to be a truly remarkable finding. Whilst the number of babies born with HIV has been reduced dramatically in recent years, by the development of better antenatal drugs and prevention strategies, it remains a grave problem in developing countries, with many children being born with the infection each year through lack of access to necessary antiretroviral drugs.
The case represents a landmark in medical history, but doctors, including Dr. Hannah Gay, are keen to stress that this could be no more than a highly unusual response to the medication, rather than a cure to be replicated in other new-born babies. Until scientists can find out exactly how the child was cured, Gay emphasised the importance of prevention as the best way to stop the transmission of the virus between mother and child. Speaking to the Guardian, Gay said: “Prevention really is the best cure, and we already have proven strategies that can prevent 98% of new-born infections by identifying and treating HIV-positive women.”
Sources include: The Guardian, BBC, Foundation for Aids Research
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