Doctors have confirmed that they have “cured” a baby born with HIV. The baby, now a girl of 3 years, was born in Mississippi and after being tested as HIV-positive underwent extreme treatment using drug therapy. At first, doctors were skeptical that the little girl was actually infected but a report released by the New England Journal of Medicine on Wednesday this week revealed that she was indeed HIV positive when she was still in the womb. Doctors subjected her to abnormally intense treatment and now, 18 months since her last antiretroviral medication, tests shows no active level of HIV-1 RNA.
This heralds the first time that HIV has gone into remission using drug therapy and doctors are hopeful that this is a breakthrough in treating others with the virus. Doctors have not been touting this as a cure since there is no proof stating the length of time required in announcing someone to be free of HIV.
Timothy Ray Brown is the only other person known to be “cured” of the HIV virus. Brown was diagnosed with acute myeloid leukemia and doctors found a bone marrow donor who was immune to the HIV virus due to a rare mutation in the genes that inhibits HIV from penetrating the cells. This method of treatment is not viable for the 30 million plus that are HIV positive. Research is being done to find a safe and effective way of introducing the gene mutation to patients.
During the 12 months of the patient’s life, breast feeding was denied and the girl underwent anti retroviral treatment (ART). At 18 months of age the red-cell mean corpuscular volume had decreased significantly and questions about the need to continue medication was raised. According to the report, the plasma levels were undetectable at this stage at <20 copies / milliliter.
The mother stopped bringing the child for regular clinic visits after the age of 18 months. The mother returned for a clinical visit 5 months later, reporting to the clinic that ART had stopped at 18 months and pharmacy records reveal the last refill for ART when the girl was 15 months old. Doctors expected that the child’s viral count would have sky rocketed after drug therapy had been stopped but they were surprised when they saw the results. Blood samples taken at 23 and 24 months record that the HIV-1 RNA’s plasma level completely undetectable. Test (HIV-1 DNA polymerase-chain-reaction test) results came back negative as well as an HIV-1 antibody test.
The child has since refrained from any antiretroviral drugs and routine clinical assays show that HIV-1 RNA plasma level remains undetected.
Curiously, reports indicate that the mother received no pre natal care and was only discovered to be HIV positive when she entered labor. For this reason, doctors assumed the baby to be in high risk and began the intense treatment right away (30 hours after birth). The immediate treatment with three powerful ART drugs is considered to be the main reason for the baby’s remission of the HIV virus. Doctors suggest that the virus had no time to establish itself in the body and was therefore more readily rooted out. The label of “cure” is a tentative one and the US government has sponsored a study that will commence in January. The aim of the study is to test the effect of early treatment in HIV positive infants. If the results of the Mississippi girl can be reproduced, then babies born with the virus could face a future free from HIV.