|
| This image provided by Johns Hopkins Medicine shows Dr. Deborah Persaud of Johns Hopkins' Children's Center in Baltimore. A baby, born with the AIDS virus, appears to have been cured scientists announced Sunday, March 3, 2013, 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. If the child remains free of HIV, it would mark only the world's second known cure. Specialists say the finding offers exciting clues for how to eliminate HIV infection in children. "Maybe we'll be able to block this reservoir seeding," Persaud said. |
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.
WASHINGTON
(AP) -- 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 2 1/2 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.
"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.
The United Nations agency that guides the global fight against HIV/AIDS, known as UNAIDS, hailed the news.
"This
news gives us great hope that a cure for HIV in children is possible
and could bring us one step closer to an AIDS-free generation," said
UNAIDS Executive Director Michel Sidibe. "This also underscores the need
for research and innovation especially in the area of early
diagnostics."
