Cautious Optimism About 'Cure' for Babies With HIV
Report on second child raises hope that early, aggressive treatment may be game changer for these infants
By Dennis Thompson
THURSDAY, March 6, 2014 (HealthDay News) -- The hope that newborns can be "cured" of HIV -- the virus that causes AIDS -- with early, aggressive drug treatment was bolstered this week with the announcement that a second baby appears to be free of the virus following therapy that began just four hours after her birth.
The child, born at Miller Children's Hospital in Long Beach, Calif., is now 9 months old and is considered HIV-negative, researchers reported Wednesday at the Conference on Retroviruses and Opportunistic Infections in Boston.
The first baby apparently cured by early drug therapy -- the so-called "Mississippi baby" -- is now more than 3 years old and also remains free of HIV infection, said Dr. Deborah Persaud, an associate professor of pediatrics in the division of infectious diseases at Johns Hopkins Children's Center in Baltimore.
Persaud, who presented the findings Wednesday on the California baby, has also been involved with continued monitoring of the Mississippi baby.
While the two cases have key differences, taken together they seem to indicate that newborns can be cured of infection with HIV if doctors begin treatment within hours of birth.
A federally funded clinical trial will start within a couple of months to arrive at a more scientific assessment of the treatment, said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases.
In the trial, as many as 60 babies who are born with HIV will be put on an antiretroviral drug regimen within 48 hours of birth.
The results of the trial could change the way doctors treat HIV-infected newborns, altering thinking that up until now has favored caution because these drugs can be extremely toxic.
"You have to get the data from the trial. You don't want to jump ahead of yourself," Fauci said. "But data that shows when you treat a baby immediately you can actually cure a baby, that changes the equation of risk/benefit. That makes a doctor lean much more toward immediate treatment."
More than 1,000 babies are born with HIV every day around the globe, according to UNICEF.
The mother of the California baby has advanced AIDS and is mentally ill, researchers said. She had been prescribed HIV medications to protect her baby, but had not taken them, according to published reports.
Normally, doctors put children born to HIV-positive mothers on a two-medication regimen until the virus appears in the babies' bloodstream, which can take as long as two weeks. At that point, they move to a more aggressive three-drug regimen.
But in the cases of the Mississippi and California babies, doctors chose to quickly put the newborns on the more aggressive regimen, with stunning results.