Today’s headlines have been accompanied by news of the second successful treatment in a baby born with HIV. Born in Long Beach California, the baby girl was placed on an aggressive drug treatment within hours after she was born. Known as the “Los Angeles baby,” she was born at Miller Children’s Hospital Long Beach in April of last year and will be the second successful HIV remission baby, after the first baby whose successful treatment was announced last year in Mississippi.
The Los Angeles’ baby’s case was disclosed at the Boston Conference on Retroviruses and Opportunistic Infection on Wednesday. News of this comes almost a year after the first successful account was reported in Mississippi. The Mississipi child, who is now 3-1/2 years old, stopped receiving treatment two years ago and is still in remission. The Los Angeles baby who has been given a similar drug treatment, while currently in remission, is still receiving three drugs for anti-AIDS treatment.
Both babies were birthed by mothers who were infected with HIV, which compromises the immune system and can potentially lead to AIDS. While medications exist that help reduce the transmission of HIV from the mother to the fetus, in the case of the Mississippi mother, she had been unaware that she was HIV positive until she went into labor. The Los Angeles Baby’s mother, however, was aware that she was infected, yet she had been reluctant to take her medication to prevent transmission to the baby.
For babies born of mothers who are HIV positive, there is a 20 to 25 percent chance of contracting the mother’s HIV; in other words, babies are 80 to 85 percent likely not to receive the infection from their mothers. As a preventive measure, mothers who are HIV positive are placed on a course of treatment to reduce the transmission of HIV to one percent. But, if the opportunity for preventive treatment is missed, there are aggressive treatments that can be offered to the baby once they are born.
The Los Angeles baby was put on a course of three medications: AZT, 3TC, and nevirapine, which succeeded in bringing about the remission of HIV. The doses newborns receive are higher than usual for normal treatment purposes and previously were not recommended for use in newborns. Typically babies at risk for contracting HIV are first given just neviraprine for six weeks, the time it takes for the mothers antibodies to be eliminated from the baby’s body. This reduces the risk of a baby being treated with aggressive drugs when they only test false positive, which occurs in babies more frequently than actual HIV positive results. If the baby does test positive after the initial six week period then they are given the other two drugs in addition to nevirapine with hope that it would cause the infection to go into remission.
With the Los Angeles baby in successful remission for HIV, the question remains of whether or not to take the baby off her treatment. Doctor Yyvone Bryson, an infectious disease specialist at UCLA states that this is uncharted territory, and the only way to be certain that the baby is in remission is, “to stop the therapy.” While taking the baby off the medication is ultimately the goal, Dr. Audra Deveikis, a disease specialist from Miller Children’s Hospital, expresses the need to proceed with caution. Deveikis says that the basis of removing the infant from treatment should depend upon the results of 60 upcoming clinical trials of infant HIV cases that will further support their findings, concluding that, “We’re going to continue for at least two years.. depending on the information we get.” Even though the little Los Angeles baby might still be on her medication, it’s still very exciting to know that she has greater chances of continuing on in life HIV free.
By Natalia Sanchez