A baby born with the virus
that causes AIDS appears to have been cured, scientists announced Sunday,
describing the case of a child from Mississippi who's now 2½ and has been off
medication for about a year with no signs of infection.
There's no guarantee the
child will remain healthy, although sophisticated testing uncovered just traces
of the virus' genetic material still lingering.
If so, it would mark only
the world's second reported cure. Specialists say Sunday's announcement, at a
major AIDS meeting in Atlanta, offers promising clues for efforts to eliminate
HIV infection in children, especially in AIDS-plagued African countries where
too many babies are born with the virus.
"You could call this
about as close to a cure, if not a cure, that we've seen," Dr. Anthony
Fauci of the National Institutes of Health, who is familiar with the findings,
told The Associated Press. A doctor gave this baby faster and stronger
treatment than is usual, starting a three-drug infusion within 30 hours of
birth. That was before tests confirmed the infant was infected and not just at
risk from a mother whose HIV wasn't diagnosed until she was in labor. "I
just felt like this baby was at higher-than-normal risk, and deserved our best
shot," Dr. Hannah Gay, a pediatric HIV specialist at the University of
Mississippi, said in an interview. That fast action apparently knocked out HIV
in the baby's blood before it could form hideouts in the body.
Those so-called reservoirs
of dormant cells usually rapidly reinfect anyone who stops medication, said Dr.
Deborah Persaud of Johns Hopkins Children's Center. She led the investigation
that deemed the child "functionally cured," meaning in long-term
remission even if all traces of the virus haven't been completely eradicated.
Next, Persaud's team is
planning a study to try to prove that, with more aggressive treatment of other
high-risk babies. "Maybe we'll be able to block this reservoir
seeding," Persaud said. No one should stop anti-AIDS drugs as a result of
this case, Fauci cautioned. But "it opens up a lot of doors" to
research if other children can be helped, he said. "It makes perfect sense
what happened." Better than treatment is to prevent babies from being born
with HIV in the first place. About 300,000 children were born with HIV in 2011,
mostly in poor countries where only about 60 percent of infected pregnant women
get treatment that can keep them from passing the virus to their babies. In the
U.S., such births are very rare because HIV testing and treatment long have
been part of prenatal care.
"We can't promise to
cure babies who are infected. We can promise to prevent the vast majority of
transmissions if the moms are tested during every pregnancy," Gay
stressed. The only other person considered cured of the AIDS virus underwent a
very different and risky kind of treatment — a bone marrow transplant from a
special donor, one of the rare people who is naturally resistant to HIV.
Timothy Ray Brown of San Francisco has not needed HIV medications in the five
years since that transplant.
The Mississippi case shows
"there may be different cures for different populations of HIV-infected
people," said Dr. Rowena Johnston of amFAR, the Foundation for AIDS
Research. That group funded Persaud's team to explore possible cases of
pediatric cures. It also suggests that scientists should look back at other
children who've been treated since shortly after birth, including some reports
of possible cures in the late 1990s that were dismissed at the time, said Dr.
Steven Deeks of the University of California, San Francisco, who also has seen
the findings.
"This will likely
inspire the field, make people more optimistic that this is possible," he
said. In the Mississippi case, the mother had had no prenatal care when she
came to a rural emergency room in advanced labor. A rapid test detected HIV. In
such cases, doctors typically give the newborn low-dose medication in hopes of
preventing HIV from taking root. But the small hospital didn't have the proper
liquid kind, and sent the infant to Gay's medical center. She gave the baby
higher treatment-level doses. The child responded well through age 18 months,
when the family temporarily quit returning and stopped treatment, researchers
said. When they returned several months later, remarkably, Gay's standard tests
detected no virus in the child's blood.
Ten months after treatment
stopped, a battery of super-sensitive tests at half a dozen laboratories found
no sign of the virus' return. There were only some remnants of genetic material
that don't appear able to replicate, Persaud said. In Mississippi, Gay gives
the child a check-up every few months: "I just check for the virus and
keep praying that it stays gone." The mother's HIV is being controlled
with medication and she is "quite excited for her child," Gay added.
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