Researchers describe first 'functional HIV cure' in an infant - 0 views
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A team of researchers from Johns Hopkins Children's Center
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The infant described in the report underwent remission of HIV infection after receiving antiretroviral therapy (ART) within 30 hours of birth
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investigators say the prompt administration of antiviral treatment likely led to this infant's cure by halting the formation of hard-to-treat viral reservoirs
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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
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dormant cells responsible for reigniting the infection in most HIV patients within weeks of stopping therapy
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"functionally cured," a condition that occurs when a patient achieves and maintains long-term viral remission without lifelong treatment and standard clinical tests fail to detect HIV replication in the blood
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a functional cure occurs when viral presence is so minimal, it remains undetectable by standard clinical tests, yet discernible by ultrasensitive methods
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was born to an HIV-infected mother and received combination antiretroviral treatment beginning 30 hours after birth.
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A series of tests showed progressively diminishing viral presence in the infant's blood, until it reached undetectable levels 29 days after birth
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The infant remained on antivirals until 18 months of age, at which point the child was lost to follow-up for a while
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Ten months after discontinuation of treatment, the child underwent repeated standard blood tests, none of which detected HIV presence in the blood
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Test for HIV-specific antibodies—the standard clinical indicator of HIV infection—also remained negative
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Currently, high-risk newborns—those born to mothers with poorly controlled infections or whose mothers' HIV status is discovered around the time of delivery—receive a combination of antivirals at prophylactic doses to prevent infection for six weeks and start therapeutic doses if and once infection is diagnosed
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natural viral suppression without treatment is an exceedingly rare phenomenon observed in less than half a percent of HIV-infected adults
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"elite controllers," whose immune systems are able to rein in viral replication and keep the virus at clinically undetectable levels
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investigators caution they don't have enough data to recommend change right now to the current practice of treating high-risk infants
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but the infant's case provides the rationale to start proof-of-principle studies in all high-risk newborns
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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
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in an HIV-positive man treated with a bone marrow transplant for leukemia. The bone marrow cells came from a donor with a rare genetic mutation of the white blood cells that renders some people resistant to HIV
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Such a complex treatment approach, however, HIV experts agree, is neither feasible nor practical for the 33 million people worldwide infected with HIV
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Prevention really is the best cure, and we already have proven strategies that can prevent 98 percent of newborn infections by identifying and treating HIV-positive pregnant women