Girl Thought Cured of HIV Shows Signs of Infection
After more than two years of no drug therapy, she's back on medication; development disappoints doctors, researchers
By Dennis Thompson
THURSDAY, July 10, 2014 (HealthDay News) -- A Mississippi girl born with HIV who was thought to be cured by immediate and aggressive drug treatment has relapsed, with new tests showing detectable levels of the AIDS-causing virus in her bloodstream, disappointed federal officials announced Thursday afternoon.
The girl, now nearly 4 years old, had remained virus-free even though she stopped taking HIV medications when she was 18 months old. Doctors had hoped her remission would open the door to a functional cure for all children born with the virus.
But a blood test taken during a routine clinical care visit earlier this month uncovered detectable HIV levels in her blood. Additional testing found that the girl also had a decreased white blood cell count and the presence of HIV antibodies, both of which are signs that an actively replicating pool of HIV has established itself in her body.
"Certainly, this is a disappointing turn of events for this young child, the medical staff involved in the child's care, and the HIV/AIDS research community," said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases. "Scientifically, this development reminds us that we still have much more to learn about the intricacies of HIV infection and where the virus hides in the body."
Genetic tests determined that the child's HIV infection is the same strain acquired from her mother.
Doctors have placed the girl back on antiretroviral therapy, which has successfully decreased her viral levels with no side effects.
Researchers had believed that early treatment with a panel of antiretroviral drugs had prevented HIV from gaining a foothold in the girl's immune system. It appeared that the virus had been unable to create a reservoir in her body in which dormant HIV could hide and later reignite when she stopped taking medication.
"The fact that this child was able to remain off antiretroviral treatment for two years and maintain quiescent virus for that length of time is unprecedented," said Dr. Deborah Persaud, a professor of infectious diseases at the John Hopkins Children's Center in Baltimore and one of the two pediatric HIV experts involved in the ongoing analysis of the case. "Typically, when treatment is stopped, HIV levels rebound within weeks, not years."
Fauci said Thursday that this early treatment "did not completely eliminate the reservoir of HIV-infected cells that was established upon infection, but may have considerably limited its development and averted the need for antiretroviral medication over a considerable period."
"Now we must direct our attention to understanding why that is and determining whether the period of sustained remission in the absence of therapy can be prolonged even further," he concluded.