By Andrea K. Walker
10:01 PM EST, March 3, 2013
A Mississippi infant born with HIV has become the first child cured of the deadly virus, leaving hope that the disease can be eliminated in the youngest patients, scientists from Johns Hopkins Children’s Center and other institutions said Sunday.
The infant, who was born to an HIV-infected mother, was given antiretroviral treatment beginning 30 hours after birth. Scientists believe the early intervention may have proven key to curing the child, who is now 2 1/2 years old.
The infant has been determined “functionally cured,” said the scientists, some of whom are from the University of Mississippi Medical Center and the University of Massachusetts Medical School. A functional cure means the virus is undetectable by clinical tests but that viral traces may still be found in the body.
The news was announced Sunday at the 20th Conference on Retroviruses and Opportunistic Infections in Atlanta.
“This is really an important step to learning how to cure HIV in children and help spare the lifetime of treatment this infection brings,” said Dr. Deborah Persaud, a virologist at Hopkins Children’s Center and lead author of the report.
The treatment, which included three different drugs, may have prevented the virus from entering cells in the immune system, where it can lay dormant for many years and later trigger the virus, said Dr. Hannah Gray, a University of Mississippi Medical Center associate professor of pediatrics who treated the child.
The drugs also prevented the virus from replicating in active immune cells. When the infected cells died off, there were none in storage to replace them, Gray said.
Other infants have been treated with the same drugs, but once the medicine was stopped, infected cells stored in the immune system began circulating again.
Children with HIV most often get the disease from their mother during pregnancy, labor and delivery or breast-feeding, according to the Centers for Disease Control and Prevention. Transmission during pregnancy can be reduced drastically if the mother is treated.
The child in the study was born in a rural Mississippi hospital to a mother who did not know she was HIV positive, and therefore did not take antiviral medicines, the researchers said. When the woman was diagnosed, she was too far along in delivery for treatment.
The virus reached undetectable levels when the baby was 29 days old, but the infant continued receiving treatment.
The mother gave the medicine appropriately until the baby was 15 months old, when she started missing doses. The mother stopped treating the child altogether at 18 months old, then stopped bringing the infant to the hospital for treatment for a 10-month period.
To the surprise of doctors, when she returned with the baby, blood tests showed no signs of the virus. An antibody test also showed no signs of HIV.
The child, who is not being identified because of privacy concerns, is believed to be the second person cured of the disease. Timothy “Ray” Brown showed no signs of the virus after receiving bone marrow transplants in 2007 and 2008 for leukemia. The bone marrow donor had a rare genetic mutation of white blood cells that made him resistant to HIV.
However, his apparent cure caused debate among scientists recently when traces of HIV genes were detected in his body.
Scientists say it is too early to know whether the treatment used on the Mississippi child will work in other infants, but the findings can be implemented into current studies looking at HIV in children.
“It has huge implications for the care and treatment of HIV-infected children worldwide,” Persaud said.
Copyright © 2013, The Baltimore Sun