[SCIENTIFIC BREAKTHROUGH] **A Toddler functionally cured
of HIV. **A 2-year-old Mississippi girl is
the first child to be"functionally
cured" of HIV , researchers
announced Sunday.--CNN Researchers said they believe
early intervention -- in this case
within 30 hours of birth -- with
three anti-viral drugs was key to
the outcome.
A "functional cure " is when the presence of the virus is so
small,lifelong treatment is not
necessary and standard clinical
tests cannot detect the virus in
the blood.
The finding was announced at the 2013 Conference on
Retroviruses and Opportunistic
Infections in Atlanta.
The unidentified girl was born
HIV -positive to a mother who
received no prenatal care and was not diagnosed as HIV -
positive herself until just
beforedelivery.
"We didn't have the
opportunityto treat the mom
during the pregnancy as we would like to be able do to
prevent transmission to the
baby," said Dr. Hannah Gay.
Gay, a pediatric HIV specialist at
the University of Mississippi
Medical Center, told CNN the timing of intervention in this
case, before the baby was
diagnosed HIV -positive, may
deserve "more emphasis than
the particular drugs or number
of drugs used." "We are hoping that future
studies will show that very
earlyinstitution of effective
therapy will result in this same
outcome consistently," she said
on the eve of the conference. High-risk exposure
Dr. Katherine Luzuriaga, an
immunologist at the University
of Massachusetts who worked
closely with Gay, called the
developments fascinating, including the fact that the
toddler was found to have no
virus in her blood even after
hermother stopped giving her
treatment for eight to 10
months. "This is the very first case in
which we've conclusively been
able to document that the baby
was infected and then after a
period of treatment has been
able to go off treatment withoutviral rebound,"
Luzuriaga told CNN .
Because it was determined the
Mississippi mother was HIV -
positive, once the baby was
delivered, Gay immediately began giving the infant
antiretroviral drugs in an
attempt to control HIV
infection.
Read more: Why youths aren't
getting tested for HIV "We started therapy as early as
possible, which in this case
wasabout 30 hours of age," the
physician said. "And because it
was a high-risk exposure, I
decided to use three drugs rather than one."
Within a couple of days, Gay
confirmed that the child was
HIV positive. She says the baby
had probably been infected in
the womb. The child remained on
antiretroviral drugs for
approximately 15 months. Her
mother then stopped
administering the drug for
some reason and care was resumed after health officials
intervened, Gay said.
Researchers have long known
that treating HIV -positive
mothers early on is important,
because they pass antibodies on to their babies.
"One hundred percent of ( HIV -
positive) moms will pass those
antibodies, but in the absence
of treatment, only 30% of
momswill transmit the actual virus," Luzuriaga told CNN .
HIV -positive mothers given
appropriate treatment pass the
virus on in less than 2% of
cases, Luzuriaga said.
"So all babies are born antibody positive, but only a fraction of
babies born to HIV positive
women will actually get the
virus, and that fraction
dependson whether the mom
and baby are getting antiviral prophylaxis (preventative
treatment) or not,"said
Luzuriaga.
Newborns are considered high-
risk if their mothers' HIV
infections are not under controlor if they are found to be
HIV -positive when they're close
to delivering.
Moving quickly to suppress
thevirus
Usually, these infants would get anti-viral drugs at preventative
doses for six weeks to prevent
infection, then start therapy if
HIV is diagnosed.
Investigators say the Mississippi
case may change that practice because it highlights the
potential for cure with very
early standard antiretroviral
therapy (ART). ART is a combination of at least
three drugs used to suppress
the virus and stop the
progression of the disease.
But they do not kill the virus.
Tests showed the virus in the Mississippi baby's blood
continued to decrease and
reached undetectable levels
within 29 days of the initial
treatment.
Dr. Deborah Persaud, a virologist with Johns Hopkins
Children's Center, was lead
author on the report.
The early treatment likely led to
the infant's cure , she said.
'Like pulling teeth' to get doctors to test for HIV
"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,"
Persaud says.
Persaud and Luzuriaga are part
of a group of researchers working to explore and
document possible pediatric
HIV cure cases. The group was
funded by a grant from amfAR,
the Foundation for AIDS
Research; and the National Institutes of Health.