A baby girl born in Mississippi with HIV has been “functionally cured” of the disease. This is the first time such a case has been documented. A patient is functionally cured when standard tests for HIV shows negative but there is a possibility of a tiny amount of the virus remaining in the body.
“Now, after at least one year of taking no medicine, this child’s blood remains free of virus even on the most sensitive tests available,” Dr. Hannah Gay, a pediatric HIV specialist said.
The mother of the girl had been tested positive for HIV infection. This was during the birth of the child. The mother had not received any prenatal care for the disease and so the doctors knew that the child would be born with a high risk of infection. They transferred the child to the University of Mississippi Medical Center in Jackson, where she came under the care of Dr. Gay.
Thirty hours after birth, Dr. Gay put the child on a cocktail of three standard HIV-fighting drugs. This was before the lab tests came back confirming her infection. In such cases the standard procedure would be to give the child a single antiretroviral drug to reduce her infection risk.
This heavy-dose treatment is what the researchers believe resulted in the child’s cure 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. This was taken due to the fact that the mother had not received any care during her pregnancy.
For the next year, the mother and child began to visit the clinic regularly. But eventually they stopped coming for unknown reasons. The child did not see the doctor from when she was eighteen months till she was two years old.
“We did not see this child at all for a period of about five months,” Gay told the Guardian. “When they did return to care aged 23 months, I fully expected that the baby would have a high viral load.”
Gay ordered several tests when the mother and child arrived back at the clinic, expecting the virus to have returned to high levels. But she was stunned by the results. “All of the tests came back negative, very much to my surprise,” she said.
“My first thought was, ‘Oh my goodness, I’ve been treating a child who’s not actually infected,’ ” Gay says. But a look at the earlier reports confirmed the child had been infected with HIV at birth. So Gay then thought the lab must have made a mistake with the new blood samples. So she ran those tests again with different labs. And all tests came back negative.
A couple of tests have intermittently found pieces of HIV DNA and RNA, but no evidence that the virus is actively replicating in the child’s cells.
“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. She calls this “definitely a game-changer.”
This would mark as the world’s only second reported cure of the disease. The other case had been that of Timothy Brown in Berlin, Germany. His treatment involved a bone marrow transplant from a donor who was genetically immune to HIV.
But the second case of the child stands out because this can be replicated using standard, readily available medications.
Plans are under way to study effects of such early aggressive treatments and possibilities of replicating the success they have had in Mississippi. As such the researchers hope to save the lives of nearly a 1,000 babies born each day to HIV infected parents in the developing world.