March 4, 2013
Baby Born With HIV Is Functionally Cured
In a first for HIV medicine, a baby has been functionally cured of HIV after physicians treated the infant with antiretrovirals (ARVs) beginning about 30 hours after the child was born, which is not common, The New York Times reports. Scientists from the Johns Hopkins Center in Baltimore and the University of Massachusetts Medical School in Worcester announced the results of this case study during the opening of the Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta.
Following further research, this medical breakthrough may revolutionize the care of infants born with HIV around the world, as well as lead to new insights about the formation of viral reservoirs that make curing HIV otherwise so difficult.
To date, only one other known person in the world, the so-called “Berlin Patient,” has been cured of the virus. In his case, it was a sterilizing cure, in which all virus is removed from the body. In the baby's case, the functional cure allows the immune system to control the virus.
Now 2 years old, the child was born prematurely in rural Mississippi at 35 weeks to an HIV-positive mother who had not received prenatal care or ARVs. The child maintains an undetectable viral load even after remaining off ARVs for 10 months. Due to the high risk of mother-to-child transmission, physicians began the baby on liquid ARV treatment with AZT (zidovudine), Epivir (lamivudine) and Viramune (nevirapine). They confirmed the child's HIV infection on the second day of life with two blood samples that were analyzed through polymerase chain reaction (PCR) testing. Repeat testing confirmed the HIV-positive diagnosis. After one week of life, the infant left the hospital and was kept on a cocktail of AZT (zidovudine), Epivir (lamivudine) and co-formulated Kaletra (lopinavir) with ritonavir, which is the standard treatment for babies born with HIV. While viral load tests initially confirmed the infection, their levels dropped to less than 50 by the child's 29th day of life.
|Deborah Persaud, MD, associate
professor of infectious diseases at the Johns Hopkins Children's Center
and lead author of the report.
At 18 months of age, the child's ARVs were discontinued for unknown reasons. About half a year later, medical professionals cared for the child again and discovered that the child maintained an undetectable viral load (less than 20) and had no HIV antibodies. After screening the child with a highly sensitive viral RNA and DNA test, the medical team found extremely low viral levels.
“This case suggests that providing antiretroviral therapy within the very first few days of life to infants infected with HIV through their mothers via pregnancy or delivery may prevent HIV from establishing a reservoir, or hiding place, in their bodies and, therefore, achieve a cure for those children,” said Deborah Persaud, MD, associate professor of infectious diseases at the Johns Hopkins Children’s Center, who presented the findings at CROI.
To read the National Institute of Allergy and Infectious Diseases release, click here.
To read the New York Times article, click here.
Search: CROI 2013, Cure, Functional Cure, Johns Hopkins, Deborah Persaud
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comments 1 - 15 (of 19 total) next
Rene, south Africa, 2013-04-26 21:53:51
If that's realy true than the cure shold be found, better why don't these goverments just functionally cure everyone living with this virus, while they keeping looking for the realy cure, people nobody wants to live in fear of knowing that your death is just around the coner, and what I would like to know is why isn't this functioanl cure not in our countries there are people here to living with this virus in need of the functional cure please help.
Frederick Wright, Coachelle Valley, 2013-03-17 23:19:45
June, I do the same thing for years and years. Never 100 percent complaint, for I see all the people that follow the scrip's gray and unhealthy or the many I seen die from liver failure and kidney failure. Yes the pills are better than ever. Good for you in your critical thinking for one side doesn't fit all. I have always been honest with my Doctors; even those many told me to lie for one day they will kick you out for not following their commands, and they have, but makes my faith stronger
Frederick Wright, Coachelle Valley, 2013-03-17 23:05:59
This is exciting new for a least we are getting the Scientific Community and HIV community the exposure to say the Word .. Cure.. and how easy it is to roll off one's lips. I think it is most fascinating the science always need to add another word to a statement to protect the uneducated so they want get to excited out hope and wholeness in the future, Like Function Cure, Eradicated Cure. I like the HIV folks to imagine them selves being cured and then imagine what would be different with acure
Roger, Denver, 2013-03-10 16:08:53
I'm curious of the implications from such a discovery. Will we begin treating new borns in undeveloped countries in this manner? What hope does this bring to the economy of such nations? Where do we really go from here?
June, Houston, 2013-03-07 11:59:23
I have missed over a month of meds and my viral load remained undetectable and my tcells above 300....Am I cured? I think not. It's alot doctors dont know because Ive been taking half the meds prescribed for over 2yrs and my viral load has remained undetected(yes my doctors know they still inform me to take the full dose..the same given to a 200bls man..i weigh 112 barely). Thinking HIV and AIDS is getting weaker and a cure is in sight. This is a long fought war that we will desovle its self.
Keith, EU, 2013-03-06 23:02:42
Jim and Danielle
I dont know how much you have read on cure research but there is a distinction made between functional and sterilizing cure.
A sterilizing cure is when HIV is 100% removed from the body.
This is a functional cure which means while you still have the virus you can keep your VL low without drugs basically control your HIV and be in good health with out drugs but still be HIV+.
In the medium term a functional cure is more likely.
Christopher Kaiser, Tacoma, 2013-03-06 19:57:54
A bunch of you are really negative nancies... Maybe this is the cure, maybe something they did will lead to a cure... perhaps nothing. I hear you all the time every time there is a jump in science. Sometimes I really think you all want this disease, so you can feel sorry for yourselves and make others do the same. Give the rest of us some hope would ya... Life isn't that bad even with HIV... get over yourselves. Seriously. ;(
Danielle Williams, Danville VA, 2013-03-06 15:50:10
Jim, I'm with you....I'm confused
Paul, Houston, 2013-03-06 12:47:01
This is wonderful news and I thought that the article was well written and researched. To people living with HIV this announces that the medical world is still working diligently to find a cure in spite of ignorant people and attitudes and we applaud you. We are not home yet but maybe in my life time we will see a cure.
keith, EU, 2013-03-06 12:43:25
Antony- I think the 6 month thing is based on anti bodies this child received a viral load test.
In relation to getting people on drugs quickly.
People generally do not get weekly or monthly HIV tests those who get regular check ups generally get them every 3 months but most people it maybe once a year or less regularly if ever.
It is not practical and realistic for people to test every couple of weeks and start treatment there and then. It wont happen
TinnaTuloo, Springfield, 2013-03-06 11:36:53
in the Western World the rate of transmission from mother to baby. ONLY IF THE MOTHER GETS A HIV/AIDS DIAG, AND IS ON MEDS SEVERAL MONTHS BEFORE BIRTH.
Martin Katuramu, Kampala-Uganda, 2013-03-06 09:15:14
Its very impressing about the finding.
In my experience working in a molecular lab specifically on HIV cases,an HIV DNA PCR test may not be suitable to assess status of ART clients especially,because the drugs may inhibit the PCR process,however longer periods of follow up can go a long way in confirming cure on the earliest intervention,good work!
sweetpea, Salem, OR, 2013-03-05 20:40:54
How about treating the VERY newly infected in this same way....possibly that why it worked cause it was an early infection????
Antony Pincombe, , 2013-03-05 17:13:50
By the way in the Western World the rate of transmission from mother to baby is about 8% in studies in the Us in lower economic and drug affected areas it is about 13% I don't see an unacceptably high level of transmission in the Western World.
Antony Pincombe, Sydney, 2013-03-05 17:09:38
comments 1 - 15 (of 19 total) next
I am a bit puzzled here. The window period for children maintaini g HIV is 6 months after birth. A baby born HIV will develop their own immune system over the period between birth and 9 months. In this time the majority of babies develop immunity or non HIV symptoms. I find this report a bit confusing if they are giving the baby antiretrovirals straight after birth. This baby may have developed HIV immunity or non HIV symptoms naturally and all the ARVs have done is fast Track.
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