Child 'Cured' of HIV Remains Free of Virus: Report
Treatment started shortly after birth seems to have kept virus from getting a foothold in her immune system
By Dennis Thompson
WEDNESDAY, Oct. 23 (HealthDay News) -- A 3-year-old Mississippi girl apparently cured of HIV infection by aggressive treatment right after her birth remains free of the virus, her doctors report.
Early treatment with a combination of potent antiretroviral drugs appears to have kept the virus from successfully establishing a reservoir in the child's system, said immunologist Dr. Katherine Luzuriaga, of the University of Massachusetts Medical School, who is part of the research team tracking the case.
Doctors are hesitant to declare the child fully cured, but in a case update reported in the Oct. 24 issue of the New England Journal of Medicine they said that no actively replicating HIV has been found in her system by even the most sensitive tests available. The girl stopped taking HIV medication when she was 18 months old.
A couple of tests have found very low-level indications of HIV in the girl's blood, but doctors cannot tell if they are false positives or simply remnants of the eradicated virus.
"If they are remnants, the question is whether they are capable of reigniting," Luzuriaga said. "For that reason, we are calling this a remission because we want to follow the baby over a longer period of time to see if the child continues to control the virus without rebound."
The girl stands as the first documented case of HIV remission in a child. Early findings in the case were first presented in March during a scientific meeting in Atlanta, but the new report adds critical details.
The girl's pediatrician, Dr. Hannah Gay, of the University of Mississippi Medical Center, launched HIV treatment just 30 hours following her birth, according to the report.
Doctors normally put HIV-positive mothers on two antiretroviral medications prior to birth as a way of preventing transmission of the virus to their unborn children, Luzuriaga said. After delivery, doctors test the newborns for HIV and continue treatment if the virus appears.
But in this girl's case, no one knew the mother was HIV-positive before delivery and the girl was born infected. This led Gay to put the newborn on antiretroviral treatment immediately, and that timing appears to have made a difference.
Gay also chose to employ a combination of three antiretroviral drugs, all at doses commonly used to treat HIV-infected infants, and kept the girl on the medications until she was 18 months old. This prevented the virus from mounting any drug resistance before it could be wiped clean from her body, Luzuriaga said.
Tests showed progressively diminishing HIV levels in the infant's blood, until it reached undetectable levels 29 days after birth. The child remained on antiretrovirals until 18 months of age, at which point doctors said they lost track of her and she stopped treatment.