Scientists in Mississippi appear to have cured a baby born with HIV. The child is currently two and a half years old and has been off medication for one year. There is no sign of infection, although testing shows traces of the virus’s genetic material in the child’s body, which are not replicating.
The child was born to a mother with HIV who was only diagnosed with AIDS during labour. Pregnant mothers with HIV can take medications that prevent the fetus from contracting HIV. Children who are at risk of contracting HIV during birth usually receive a low-dose liquid medication to prevent the virus from taking hold in their systems. This medication was not available at the rural hospital where the child was born, thus the child was transported to the University of Mississippi Medical Centre.
There, the child was found to have a high level of virus in their blood, showing that the virus was probably contracted while in the womb. The medical team, led by Dr. Hannah Gay, the pediatric HIV specialist at the university, set the child on an aggressive treatment plan, starting with a three-drug infusion 30 hours after birth, which is earlier than usual. Treatment continued until the child was 18 months of age.
The early treatment prevented the virus from forming reservoirs of dormant cells within the body. In most patients, these reservoirs rapidly reinfect anyone who stops medication. As such, ceasing treatment is seen as death sentence. However, the child in this case has been off medication for 10 months, and in long-term remission. As the child is unlikely to require more treatment in the foreseeable future, the child is deemed to be functionally cured.
This is only the second time that a person has had HIV eradicated from their body. The other case was that of Timothy Ray Brown who received a bone-marrow transplant in 2007 for leukemia. His donor was an individual with a mutation that made white blood cells resistant to HIV. Brown has not required HIV treatment in the five years since receiving the transplant. Unfortunately, bone marrow transplants are dangerous, require the patient’s own immune system to be destroyed, and have severe potential side effects like skeletal pain, deep vein thrombosis, fatigue, and death. Combined with the rarity of the relevant genetic mutation, bone marrow transplants are an unsuitable solution for large-scale HIV treatments.
Future research may focus on the impact of early and aggressive treatment in other infants born with a high risk of HIV infection. Researchers and public policy makers may also slowly shift work from the development of HIV prevention to an HIV cure for the 34.2 million people worldwide who currently live with HIV.
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