Monday, 4 March 2013

US HIV baby 'cured' by early drug treatment



HIVThe human immunodeficiency virus (HIV) attacks the immune system

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A baby girl in the US born with HIV appears to have been cured after very early treatment with standard drug therapy, doctors say.
The Mississippi child is now two-and-a-half years old and has been off medication for about a year with no signs of infection.
More testing needs to be done to see if the treatment - given within hours of birth - would work for others.
If the girl stays healthy, it would be the world's second reported 'cure'.

Analysis

There is currently no cure for HIV.
This latest case of a baby girl in the US who was treated within hours of birth and has since been disease-free off HIV medication does not mean we have found this Holy Grail.
While the findings are encouraging, it remains to be seen if the treatment will provide permanent remission.
Experts also say the same treatment would not work in older children and adults with HIV as the virus will have already become too established.
Public health doctors say prevention is still the best way to beat HIV.
If expectant mothers with HIV are given anti-HIV treatment during pregnancy and then have a low-risk Caesarean delivery and do not breastfeed, their babies have a 98% chance of being HIV negative.
Dr Deborah Persaud, a virologist at Johns Hopkins University in Baltimore, presented the findings at the Conference on Retroviruses and Opportunistic Infections in Atlanta.
"This is a proof of concept that HIV can be potentially curable in infants," she said.
Cocktail of drugs
In 2007, Timothy Ray Brown became the first person in the world believed to have recovered from HIV.
His infection was eradicated through an elaborate treatment for leukaemia that involved the destruction of his immune system and a stem cell transplant from a donor with a rare genetic mutation that resists HIV infection.
In contrast, the case of the Mississippi baby involved a cocktail of widely available drugs, known as antiretroviral therapy, already used to treat HIV infection in infants.
It suggests the swift treatment wiped out HIV before it could form hideouts in the body.
These so-called reservoirs of dormant cells usually rapidly reinfect anyone who stops medication, said Dr Persaud.
Dr Deborah Persaud, Johns Hopkins Children's Center: "This sets the stage for paediatric care agenda"
The baby was born in a rural hospital where the mother had only just tested positive for HIV infection.
Because the mother had not been given any prenatal HIV treatment, doctors knew the baby was at high risk of being infected.
Researchers said the baby was then transferred to the University of Mississippi Medical Center in Jackson.
Once there, paediatric HIV specialist Dr Hannah Gay put the infant on a cocktail of three standard HIV-fighting drugs at just 30 hours old, even before laboratory tests came back confirming the infection.

Start Quote

We really can quite confidently conclude at this point that the child does very much appear to be cured”
Dr Rowena JohnstonFoundation for Aids Research
"I just felt like this baby was at higher-than-normal risk and deserved our best shot," Dr Gay said.
The treatment was continued for 18 months, at which point the child disappeared from the medical system. Five months later the mother and child turned up again but had stopped the treatment in this interim.
The doctors carried out tests to see if the virus had returned and were astonished to find that it had not.
Dr Rowena Johnston, of the Foundation for Aids Research, said it appeared that the early intervention that started immediately after birth worked.
"I actually do believe this is very exciting.
"This certainly is the first documented case that we can truly believe from all the testing that has been done.
"Many doctors in six different laboratories all applied different, very sophisticated tests trying to find HIV in this infant and no body was able to find any.
"And so we really can quite confidently conclude at this point that the child does very much appear to be cured."
A spokeswoman for the HIV/Aids charity the Terrence Higgins Trust said: "This is interesting, but the patient will need careful ongoing follow-up for us to understand the long-term implications for her and any potential for other babies born with HIV."

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