Is there really an HIV cure, now that a baby has been successfully treated?
U.S. researchers have reported that a Mississippi baby girl born with HIV, the virus that causes AIDS, has been cured. The child was born to a mother who had tested positive for HIV only after the child was born – meaning that the child was at a high risk for infection.
Experts say that this is an historical case of a functional cure, which essentially occurs when a person achieves remission without the need for drugs and standard blood tests show no signs that the virus is active.
But is it a cure?
While most researches consider this to be a very rare and promising event, doctors are also warning people that there are still many more steps to be taken, and many more questions to be asked.
Why did this treatment work?
The treatment, which was administered very early to the child, involved the use of standard HIV drugs. Specifically, she was administered a cocktail of three HIV-fighting drugs – zidovudine (also known as AZT), lamivudine, and nevirapine – when she was just 30 hours old.
Researchers believe that using this more aggressive antiretroviral treatment so soon after her birth resulted in a more successful treatment by keeping the virus from forming hard-to-treat pools of cells known as viral reservoirs, which lie dormant and out of the reach of standard medications.
Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases, said although tools to prevent transmission of HIV to infants are available, many children are born infected. “With this case, it appears we may have not only a positive outcome for the particular child, but also a promising lead for additional research toward curing other children,” he said.
Will this cure work on other children?
Experts say that more testing is necessary to confirm the treatments’ effectiveness, but that these results could change the way high-risk babies born with HIV are treated.
“This is a proof of concept that HIV can be potentially curable in infants,” said Dr. Deborah Persaud, a virologist at Johns Hopkins University in Baltimore, who presented the findings at the Conference on Retroviruses and Opportunistic Infections in Atlanta.
What about Timothy Ray Brown? Is this similar situation?
The child’s story is different from the now famous case of Timothy Ray Brown, the so-called “Berlin patient,” whose HIV infection was completely eradicated through an elaborate treatment for leukemia in 2007. This treatment involved the destruction of his immune system and a stem cell transplant from a donor with a rare genetic mutation that resists HIV infection.
However, Persaud says that,”We believe this is our Timothy Brown case to spur research interest toward a cure for HIV infection in children.”
What are the next steps?
Dr. Rowena Johnston, vice president and director of research for amfAR, The Foundation for AIDS Research, which helped fund the study, said since antiretroviral therapy alone led to a cure, it is now “imperative that we learn more about a newborn’s immune system, how it differs from an adult’s and what factors made it possible for the child to be cured.”
But doctors are warning parents: Do not take your children off treatment to see if the virus comes back. Normally, when patients stop taking their medications, the virus does return, and treatment interruptions increase the risk that the virus will develop drug resistance.
“We don’t want that,” Dr. Gay said. “Patients who are on successful therapy need to stay on their successful therapy until we figure out a whole lot more about what was going on with this child and what we can do for others in the future.”