A baby born HIV positive in Mississippi two years ago has now become the first documented case of a child being cured of HIV. Her mother had received no prenatal care and no HIV testing of her own. Within 31 hours of her birth, doctors began an aggressive treatment that included three standard antiretroviral drugs.
“The child’s pediatrician in Mississippi (Dr. Hannah Gay, a pediatric HIV specialist at the University of Mississippi) was aware of the work we were doing, and quickly notified our team as soon as this young patient’s case came to her attention,” said Dr. Rowena Johnston, amfAR vice president and director of research. “Because the collaboratory was already in place, the researchers were able to mobilize immediately and perform the tests necessary to determine if this was in fact a case of a child being cured.”
The baby stayed on treatment-level doses of the antiretroviral drugs for 18 months. At that point, and for unknown reasons, her mother stopped bringing her in for follow up appointments. Five months later, the doctors found the family with the help of Child Protective Services and brought the child in for a check up.
Before resuming any treatment, a full round of tests were conducted to ensure the HIV virus hadn’t developed resistance to any of the drugs. At that point, the technicians couldn’t find any virus to test. They went back to the original tests to confirm the initial diagnosis. In this case, “the child got therapy and then went off therapy, and now there’s no detectable virus,” said Deborah Persaud, a pediatrician and AIDS researcher at Johns Hopkins Children’s Center in Baltimore and lead author of a study reporting the cure. “That’s really unheard of. If people go off therapy, most of them rebound…within a few weeks.”
“We are proud to have played a leading role in bringing this first pediatric HIV cure to light,” said amfAR CEO Kevin Robert Frost. “The case is a startling reminder that a cure for HIV could come in ways we never anticipated, and we hope this is the first of many children cured of HIV in the months and years to come.”
Although these results are earth-shattering and impressive, more studies must be conducted before calling the results official. “You have to be careful because this is just a single case and although the data looked pretty convincing that you got to be careful that this may not be broadly applicable to other situations,” Dr. Anthony Fauci said. These results involve only one patient and the results give no indication of relevance to adults or adolescents who contract HIV. If further study shows similar results for other newborns infected through their mothers, the entire standard treatment could change.
Contrary to the aggressive treatment this child encountered, World Health Organization guidelines recommend a moderate dose of antiretroviral treatment for four to six weeks. Once the results from the infant’s own HIV tests are back, treatment will either cease or accelerate. They do not advocate high dosages for newborns as the risks of over-medication exists. As well, patients who are confirmed HIV positive are in need of existing drugs.