First 'Functional Cure' of HIV in Baby?
By Amanda Gardner
SUNDAY, March 3 (HealthDay News) -- A baby born two-and-a-half years ago in Mississippi with HIV is the first case of a so-called "functional cure" of the infection, researchers announced Sunday.
Standard tests can no longer detect any traces of the AIDS-causing virus even though the child has discontinued HIV medication.
"We believe this is the first well-documented case of a [functional] cure," said study lead author Dr. Deborah Persaud, associate professor of pediatrics in the division of infectious diseases at Johns Hopkins Children's Center in Baltimore. The finding was presented Sunday at the Conference on Retroviruses and Opportunistic Infections, in Atlanta.
The child was not part of a study but, instead, the beneficiary of an unexpected and partly unplanned sequence of events that -- once confirmed and replicated in a formal study -- might help more children who are born with HIV or who at risk of contracting HIV from their mother eradicate the virus from their body.
Normally, mothers infected with HIV take antiretroviral drugs that can almost eliminate the odds of the virus being transferred to the baby.
If a mother doesn't know her HIV status or hasn't been treated for other reasons, the baby is given "prophylactic" drugs at birth while awaiting the results of tests to determine his or her HIV status. This can take four to six weeks to complete. If the tests are positive, the baby starts HIV drug treatment.
The mother of the baby born in Mississippi didn't know she was HIV-positive until the time of delivery.
But in this case, both the initial and confirmatory tests on the baby were able to be completed within one day, allowing the baby to be started on HIV drug treatment within the first 30 hours of life.
"Most of our kids don't get picked up that early," Persaud explained.
As expected, the baby's "viral load" -- detectable levels of HIV -- decreased progressively until it was no longer detectable at 29 days of age.
Theoretically, this child (doctors aren't disclosing the gender) would have taken the medications for the rest of his or her life, said the researchers, who included doctors from the University of Massachusetts Medical School and the University of Mississippi Medical Center.
Instead, the child stayed on the regimen for only 18 months before dropping out of the medical system and discontinuing the drugs.
Ten months after stopping treatment, however, the child was again seen by doctors who were surprised to find no HIV virus or HIV antibodies with standard tests.
Ultrasensitive tests did detect infinitesimal traces of viral DNA and RNA in the blood. But the virus was not replicating -- a highly unusual occurrence given that drugs were no longer being administered, the researchers said.