/ 6 March 2014

No proof that HIV-infected baby was cured

Even HIV-infected adults
Even HIV-infected adults

A nine-month-old baby who was born in California with HIV may possibly have been cured as a result of antiretroviral treatment that doctors began just four hours after her birth. Medical researchers from the Johns Hopkins School of Medicine announced this at the Conference in Reroviruses and Opportunistic Infections in Boston on Wednesday.

That child is the second case, following an earlier instance in Mississippi, in which doctors may have brought HIV in a newborn into remission by administering antiretroviral drugs in the first hours of life, said Dr Deborah Persaud, a paediatrics specialist with the Johns Hopkins School of Medicine.

"The child … has become HIV-negative," Persaud said, referring to the nine-month-old baby born outside Los Angeles, who is being treated at Miller Children's Hospital in Long Beach. The child's identify was not disclosed.

That baby from California is still receiving antiretroviral treatment, while the child born in Mississippi, now three-and-a-half years old, ceased receiving antiretroviral treatment two years ago. 

Both children were born of mothers infected with HIV. The virus drastically weakens the body’s immune system and can lead to Aids.

'No proof'
Professor Salim Abdool Karim from the Centre for Aids Programme of Research in South Africa (Caprisa), however, said that there is no proof yet that the second baby has been cured.

"The baby is only nine months old and is still on antiretroviral therapy, so the virus could in fact be hiding anywhere in the infant's immune cells – a negative HIV test, no matter how specialised, at this stage cannot provide conclusive evidence that this nine-month-old baby has been cured."

Abdool Karim said there is no available test that can determine whether a baby born to an HIV-infected mother has been cured of HIV, as the virus can theoretically return at any time. "At best we can achieve a 'functional cure', which means that all available tests to detect the virus have been consistently negative," he said.

Even HIV-infected adults, for whom antiretrovirals work well, can test HIV negative with both antibody HIV tests and specialised laboratory "PCR" tests, as the amount of virus in their bodies becomes too low for the test to detect.

'More compelling'
According to Karim, the case of the first baby from Mississippi is far more compelling as the child is no longer on antiretroviral treatment. "We can confidently say that a functional cure has been achieved in the child, as the toddler has tested HIV-negative repeatedly for a few years in the absence of antiretroviral medication that can lower the amount of HIV in her body."

While Persaud credited the early use of antiretroviral therapy with improving the children's health, she acknowledged that more research is needed. "Really the only way we can prove that we have accomplished remission in these kids, is by taking them off treatment and that's not without risk," Persaud said. "This is a call to action for us to mobilise and be able to learn from these cases." – Additional reporting by Reuters