Some researchers now claim that a second infant born with HIV has been successfully cured of its infection, while others debate that the disease is only in remission. This information adds to the discussion that was originally started back in March of 2013 when a similar case of an infant from Mississippi was also claimed to have been cured of HIV. Though the debate is still very much open, researchers are proceeding with a clinical trial that will examine whether or not early administration of antiretroviral drugs can indeed cure infants of HIV.
The first reported case of an infant being cured of HIV was made back in early 2013. Within 30 hours after birth an HIV-positive baby from Mississippi was administered antiretroviral drugs. The child is now over three years old, and is reportedly still HIV-free.
Just this Wednesday at a conference on HIV/AIDS, a second infant is also reported to have been cured of its HIV infection. As with the Mississippi case, this mother from Los Angeles was known to be HIV positive and had not taken the steps to control her own infection. During the birthing process she transmitted the virus to her daughter. Wary of this possibility but still unable to confirm the infection, doctors began administering medication to the infant about four hours after birth. Follow-up examinations reveal that this early treatment may have completely cured the infant of HIV or sent the disease deep into remission.
Still, researchers remain cautious with their enthusiasm. The Los Angeles baby is currently still receiving HIV/AIDS medications and thus may still host undetected virus. The Mississippi baby also remains well, though its treatment has since been re-labeled as a case of HIV “remission” instead of a “functional cure” to help avoid exaggerations of a still-uncertain outcome. Only time will be able to offer the definitive answer on whether or not these children are completely cured.
In addition, administering antiretroviral drugs, especially to a neonate, carries a definite degree of risk. Such medications are potentially toxic, particularly to fragile infants. Furthermore, to maximize the efficacy of these drugs they should be administered soon after birth. This means that there is no time to actually test whether or not the child is HIV positive. Thus, infants that are HIV-negative may be exposed to unnecessary risks.
Finally, another potential critique of these findings is that they might dissuade mothers from responsibly managing their own HIV infections. HIV-positive mothers that take steps to manage their own viral loads can reduce the chances of HIV transmission to 1 percent. Without this treatment, the chances of mother-to-child transmission are as high as 15 to 45 percent. Both the mothers of the Los Angeles and Mississippi babies were not on medication despite knowing their status as HIV-positive expecting-mothers. It is hoped that even if science may one day be able to cure HIV-infected infants, mothers will both take responsibility for minimizing the risks posed to their children and also to insure their own longevity as healthy, supportive parents.
Nonetheless, the evidence is encouraging enough that in the next few months doctors will begin a clinical trial of 50 HIV-infected infants. Like the Los Angeles and Mississippi babies, these neonates will receive antiretroviral drugs within 48 hours after birth. In the mean time the discussion on whether or not HIV can be irrevocably cured in infants remains open for debate.
By Sarah Takushi