‘Cured’ HIV baby shocks medics

Dr. Deborah Persaud, a virologist at Johns Hopkins Children's Center in Baltimore.
Dr. Deborah Persaud, a virologist at Johns Hopkins Children’s Center in Baltimore.

Doctors in the US are cautiously confident they have cured a baby born with HIV. The Mississippi baby, now 2 years-old, appears to be the first documented case of a child being cured of the virus, according to doctors and scientists.

The unidentified child has now been “functionally cured” and has been off medication for about a year with no signs of the HIV infection. If the child remains healthy, it would mark only the second time in the world’s history that a person has been cured of HIV, which is the virus that causes AIDS.

Genevieve Edwards, Director of Health Improvement at Terrence Higgins Trust, said: “This is interesting, but the child will need careful ongoing follow-up for us to understand the long-term implications and any potential for other babies born with HIV.  In the UK we already have a programme of ante-natal screening for HIV, which means that there are very few babies born with the virus. Expectant mothers with HIV are given anti-HIV treatment during pregnancy which together with a low-risk caesarean and no breastfeeding means their babies have a 98% chance of being HIV negative.  But this could be of interest where mothers to be are diagnosed with HIV during labour rather than pregnancy.

“The roll-out of anti-retroviral therapy across the developing world has both saved the lives of individuals living with HIV, and also had a real impact on the rates of mother-to-child transmission.  In this context, it would seem that success lies in making antenatal testing available and then giving the drugs to the mother to prevent the child getting HIV, rather than hoping the drugs will cure the baby once born HIV positive. But for those babies born with the virus, this may be significant.”

The landmark case, which will prove exciting news for Africa and the rest of the developing world, was announced on Sunday (March 3) at the 2013 Conference on Retroviruses and Opportunistic Infections in Atlanta. Dr. Deborah Persaud of Johns Hopkins University in Baltimore was one of the lead researchers and author of the report, which was released by The Foundation for AIDS Research (amfAR). The infant was diagnosed with HIV at birth to a mother who did not receive prenatal care or HIV treatment, Dr. Rowena Johnston, director of amfAR, told ABC News.

The infant was transferred to the University of Mississippi Medical Centre and started on antiretroviral treatment about 30 hours after birth. Doctors took the apparently unusual step of prescribing three aggressive drugs (AZT, 3TC, nevirapine) at once after birth. Johnston points to the early intervention of the three medications as the key. Initial HIV viral load tests were high and then expectedly decreased in the first month. Viral loads were detectable three times and became undetectable by one month of age.

The baby was on treatment and in care until 12 to 15 months of age, at which point the baby was lost to follow-up after doctors lost contact with the mother and the baby stopped receiving any medication. The baby returned for care at 23 months of age. Surprisingly, viral loads were still undetectable, despite being off treatment for almost a year. Johnston said the results were all the more shocking because doctors do not usually recommend stopping treatment at any time in children with HIV from birth.

The results surprised Dr. Hannah Gay, a paediatric HIV specialist at the University of Mississippi, who was treating the child. “My first thought was to panic. I thought, ‘Oh my goodness, I have been treating a child who is not actually infected,’” she said. A battery of “highly sensitive” tests confirmed the absence of HIV, according to a news release. In Mississippi, Dr. Gay gives the child a check-up every few months. “I just check for the virus and keep praying that it stays gone,” she told The Associated Press.

The mother’s HIV is being controlled with medication and she is “quite excited for her child,” Gay added. The only other documented case of an HIV cure to date remains that of Timothy Brown, the so-called “Berlin patient.”