Researchers say they have, for the first time, cured a baby born
with HIV -- a development that could help improve treatment
of babies infected at birth.
There is an important technical nuance: researchers insist on
calling it a "functional cure" rather than a complete cure.
That is because the virus is not totally eradicated. Still, its
presence is reduced to such a low level that a body can control
it without the need for standard drug treatment.
The only fully cured AIDS patient recognized worldwide is the
so-called "Berlin patient," American Timothy Brown. He is
considered cured of HIV and leukemia five years after
receiving bone marrow transplants from a rare donor naturally
resistant to HIV. The marrow transplant was aimed at treating
his leukemia.
But in this new case, the baby girl received nothing more
invasive or complex than commonly available antiretroviral
drugs. The difference, however, was the dosage and the timing:
starting less than 30 hours after her birth.
It is that kind of aggressive treatment that likely yielded the
"functional cure," researchers reported Sunday at the 20th
annual Conference on Retroviruses and Opportunistic
Infections (CROI) in Atlanta, Georgia.
What researchers call dormant HIV-infected cells often re-start
infections in HIV-infected patients within a few weeks after
antiretroviral treatment stops, forcing most people who have
tested HIV-positive to stay on the drugs for life or risk the
illness progressing.
"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," said lead
researcher Deborah Persaud, of Johns Hopkins Children's
Center in Baltimore, Maryland.
It appears to be the first time this was achieved in a baby, she
said.
The baby was infected by her HIV-positive mother, and her
treatment with therapeutic doses of antiretroviral drugs began
even before her own positive blood test came back.
The typical protocol for high-risk newborns is to give them
smaller doses of the drugs until results from an HIV blood test
is available at six weeks old.
Tests showed the baby's viral count steadily declined until it
could not longer be detected 29 days after her birth.
The child was given follow-up treatment with antiretrovirals
until 18 months, at which point doctors lost contact with her
for 10 months. During that period she was not taking
antiretrovirals.
Researchers then were able to do a series of blood tests -- and
none gave an HIV-positive result.
Natural viral suppression without treatment is an exceedingly
rare occurrence, seen in fewer than half a percent of HIV-
infected adults, known as "elite controllers," whose immune
systems are able to rein in viral replication and keep the virus
at clinically undetectable levels.
Experts on HIV have long wanted to help all HIV patients
achieve elite-controller status. Researchers say this new case
offers hope as a game-changer, because it suggests prompt
antiretroviral therapy in newborns indeed can do that.
Still, they said, their first priority is learning how to stop
transmission of the virus from mother to newborn. ARV
treatments of mothers currently stop transmission to newborns
in 98 percent of cases, they say.
"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 pointed
out.
The research was funded by the National Institutes of Health
and the American Foundation for AIDS Research.
Source: http://www.surestinfo.com/2013/03/hiv-cured-in-baby-for-the-first-time-scientists.html?wprptest=0