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investigators

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

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

dormant cells responsible for reigniting the infection in most HIV patients within weeks of stopping therapy

researchers say they believe this is precisely what happened in the child described in the report

"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

a sterilizing cure—a complete eradication of all viral traces from the body

a functional cure occurs when viral presence is so minimal, it remains undetectable by standard clinical tests, yet discernible by ultrasensitive methods

The child described

was born to an HIV-infected mother and received combination antiretroviral treatment beginning 30 hours after birth.

A series of tests showed progressively diminishing viral presence in the infant's blood, until it reached undetectable levels 29 days after birth

The infant remained on antivirals until 18 months of age, at which point the child was lost to follow-up for a while

Ten months after discontinuation of treatment, the child underwent repeated standard blood tests, none of which detected HIV presence in the blood

Test for HIV-specific antibodies—the standard clinical indicator of HIV infection—also remained negative

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

this particular case

may change the current practice because it highlights the curative potential of very early ART

natural viral suppression without treatment is an exceedingly rare phenomenon observed in less than half a percent of HIV-infected adults

HIV experts have long sought a way to help all HIV patients achieve elite-controller status

"elite controllers," whose immune systems are able to rein in viral replication and keep the virus at clinically undetectable levels

investigators caution they don't have enough data to recommend change right now to the current practice of treating high-risk infants

but the infant's case provides the rationale to start proof-of-principle studies in all high-risk newborns

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

A single case of sterilizing cure has been reported so far

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

Such a complex treatment approach, however, HIV experts agree, is neither feasible nor practical for the 33 million people worldwide infected with HIV

researchers say preventing mother-to-child transmission remains the primary goal

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

Bee venom contains a potent toxin called melittin that can poke holes in the protective envelope that surrounds HIV, and other viruses

in addition to anti-viral therapy, the paper's senior author

has shown melittin-loaded nanoparticles to be effective in killing tumor cells.

The new study shows that melittin loaded onto these nanoparticles does not harm normal cells

because

added protective bumpers to the nanoparticle surface

When the nanoparticles come into contact with normal cells, which are much larger in size, the particles simply bounce off

HIV, on the other hand, is even smaller than the nanoparticle, so HIV fits between the bumpers and makes contact with the surface of the nanoparticle, where the bee toxin awaits

, an advantage of this approach is that the nanoparticle attacks an essential part of the virus' structure. In contrast, most anti-HIV drugs inhibit the virus's ability to replicate.

this anti-replication strategy does nothing to stop initial infection, and some strains of the virus have found ways around these drugs and reproduce anyway.

attacking an inherent physical property of HIV

Theoretically, there isn't any way for the virus to adapt to that

potential for using nanoparticles with melittin as therapy for existing HIV infections, especially those that are drug-resistant

Since melittin attacks double-layered membranes indiscriminately, this concept is not limited to HIV.

Many viruses, including hepatitis B and C, rely on the same kind of protective envelope and would be vulnerable to melittin-loaded nanoparticles

that led doctors worldwide to rethink how fast and hard to treat infants born with HIV

In another AIDS-related development, scientists have modified genes in the blood cells of a dozen adults to help them resist HIV.

The Mississippi baby is now 3 1/2 and seems HIV-free despite no treatment for about two years

baby is still getting AIDS medicines, so the status of her infection is not as clear.

A host of sophisticated tests at multiple times suggest the LA baby has completely cleared the virus

The baby's signs are different from what doctors see in patients whose infections are merely suppressed by successful treatment,

don't know if the baby is in remission ... but it looks like

Doctors are cautious about suggesting she has been cured

Most HIV-infected moms in the U.S. get AIDS medicines during pregnancy, which greatly cuts the chances they will pass the virus to their babies

The LA baby was born

mother

was not taking her HIV medicines

Four weeks later, half of the patients were temporarily taken off AIDS medicines to see the gene therapy's effect

started the baby on them a few hours after birth. Tests later confirmed she had been infected, but does not appear to be now, nearly a year later

study in adults was prompted by an AIDS patient who appears cured after getting a cell transplant seven years ago

from a donor with natural immunity to the virus

Only about 1 percent of people have two copies of the gene that gives this protection

HIV usually infects blood cells through a protein on their surface called CCR5. A California company, Sangamo BioSciences Inc., makes a treatment that can knock out a gene that makes CCR5.

tested it in 12 HIV patients who had their blood filtered to remove some of their cells. The treated cells were infused back into the patients

The mom was given AIDS drugs during labor to try to prevent transmission of the virus

The Mississippi girl was treated until she was 18 months old, when doctors lost contact with her

Ten months later when she returned, they could find no sign of infection even though the mom had stopped giving her AIDS medicines.

a federally funded study just getting underway to see if very early treatment can cure HIV infection

About 60 babies in the U.S. and other countries will get very aggressive treatment that will be discontinued if tests over a long time, possibly two years, suggest no active infection.

The virus returned in all but one of them; that patient turned out to have one copy of the protective gene

knew that the virus was going to come back in most of the patients

the hope is that the modified cells eventually will outnumber the rest and give the patient a way to control viral levels without medicines