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Child Cured of HIV

A baby born with AIDS eighteen months ago has reportedly been cured.

NPR (“Scientists Report First Cure of HIV In A Child, Say It’s A Game-Changer“):

Scientists believe a little girl born with HIV has been cured of the infection.

She’s the first child and only the second person in the world known to have been cured since the virus touched off a global pandemic nearly 32 years ago.

Doctors aren’t releasing the child’s name, but we know she was born in Mississippi and is now 2 ½ years old – and healthy. Scientists presented details of the case on Sunday at a scientific conference in Atlanta.

The case has big implications. While fewer than 130 such children are born each year in the U.S., an estimated 330,000 children around the world get infected with HIV at or around birth every year, most of them in sub-Saharan Africa.

And while many countries are striving to prevent these mother-to-child infections, many thousands of children will certainly get infected in coming years.

Until now, such children have been considered permanently infected. Specialists thought they needed lifelong antiviral drugs to prevent HIV from destroying their immune system and killing them of AIDS.

The Mississippi child’s surprising cure came about from happenstance – and the quick thinking of a University of Mississippi pediatric infectious disease specialist named Hannah Gay.

“The child came to our attention as a high-risk exposure to maternal HIV,” Gay tells Shots. Her mother hadn’t had any prenatal care, she says, so didn’t get antiviral drugs during pregnancy.

The fact that the newborn tested positive for HIV within 30 hours of birth is a sign she was probably infected in utero, HIV specialists say.

Gay decided to begin treating the child immediately, with the first dose of antivirals given within 31 hours of birth. That’s faster than most infants born with HIV get treated, and specialists think it’s one important factor in the child’s cure.

In addition, Gay gave higher-than-usual, “therapeutic” doses of three powerful HIV drugs rather than the “prophylactic” doses usually given in these circumstances.

Over the months, the baby thrived and standard tests could detect no virus in her blood, which is the normal result from antiviral treatment.

Fantastic news, if true. Until we replicate these results, though, I’m inclined to think the initial blood test was mixed up or otherwise botched.

UPDATE: While I’m still waiting for replication, my initial concern that this is just one doctor’s interpretation based on one lab test appears unfounded. The Verge:

According to the National Institutes of Health, a two-year old child born with HIV — the virus responsible for AIDS — is now “functionally cured” of the infection following the early administration of antiretroviral therapy. [...] Scientists say it’s an unprecedented development; according to NIH, it’s the first well-documented case of an HIV-infected child who has been cured of the infection. According to The New York Times, the lead author on today’s report, Dr. Deborah Persaud of the Johns Hopkins Children’s Center, says that “it’s proof of principle that we can cure HIV infection if we can replicate this case.” Persaud says that “for pediatrics, this is our Timothy Brown,” in reference to the only other person known to have been cured of HIV. Brown, an adult, was cured via a risky bone-marrow transplant that’s difficult to replicate.

While the results are stunning and promising, the researchers in the study say that further research will be required to know whether this child’s experience can be replicated in clinical trials with other HIV-infected children. The New York Times reports that some experts need additional information, including confirmation that the baby had actually been infected, to determine if the case involved a cure or prevention of infection — prevention that can already be done for babies with infected mothers.

Dr. James Hamblin, The Atlantic’s health editor, adds:

By the time the tests did come back, they were positive — and reportedly replicated and verified five times.

So, we appear to be dealing with a legitimate scientific breakthrough. The question now is whether it will work routinely in others.

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About James Joyner
James Joyner is the publisher of Outside the Beltway, an associate professor of security studies at the Marine Corps Command and Staff College, and a nonresident senior fellow at the Atlantic Council. He's a former Army officer and Desert Storm vet. He has a PhD in political science from The University of Alabama. Views expressed here are his own. Follow James on Twitter.

Comments

  1. PJ says:

    @James Joyner:

    Fantastic news, if true. Until we replicate these results, though, I’m inclined to think the initial blood test was mixed up or otherwise botched.

    I doubt that they only tested the child’s blood once.

    Like or Dislike: Thumb up 5 Thumb down 0

  2. PJ says:

    There’s also this:

    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.

    Like or Dislike: Thumb up 2 Thumb down 0

  3. swbarnes2 says:

    Until we replicate these results, though, I’m inclined to think the initial blood test was mixed up or otherwise botched.

    Usually, HIV is confirmed in two tests; an ELISA, where it is possible to get a false positive, and then a more sensitive RT-PCR test. They might have drawn blood twice, making the odds of a mix-up less.

    @PJ:

    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.

    HIV DNA? HIV is a retrovirus, it only exists in DNA form if it has successfully integrated into the host’s cells. If it’s there, I don’t see how you can know that it won’t start replicating again.

    Like or Dislike: Thumb up 2 Thumb down 0

  4. OzarkHillbilly says:

    @swbarnes2:

    HIV is a retrovirus, it only exists in DNA form if it has successfully integrated into the host’s cells.

    via the Guardian:

    The case was so extraordinary, Dr Gay called a colleague, Katherine Luzuriaga, an immunologist at Massachusetts Medical School, who with another scientist, Deborah Persaud at Johns Hopkins Children’s Centre in Baltimore, had far more sensitive blood tests to hand. They checked the baby’s blood and found traces of HIV, but no viruses that were capable of multiplying.

    Just for purposes of clarification.

    The theory is that the use of the triple drug cocktail where as usually they only use one of them in these cases. Or at least, that is what the Guardian is reporting.

    Like or Dislike: Thumb up 0 Thumb down 0

  5. Tsar Nicholas says:

    Good news, especially for a Monday. Now the obligatory and quite rhetorical political questions:

    – Will the liberal media report which particular company’s drugs were used? Separately, but quite related, do liberals still believe that pharmaceutical companies are evil?

    – Given that this all happened in Mississippi how many “Mississippi is racist” or “the South is racist and stupid” blog posts will be published on left-wing and left-leaning blogs within the next 24-168 hours? Will the authors be able even to grasp the irony?

    – What percentage of publicly-funded or publicly-subsidized student loans, research dollars and general fund dollars should be earmarked for STEM pursuits, such as treating and perhaps curing AIDS, as opposed to liberal arts degrees, operas, paintings, NPR, diversity training and rooting out all hints of sexism everywhere?

    That all aside, with luck and skill hopefully this sort of medical result will become a trend.

    Like or Dislike: Thumb up 0 Thumb down 8

  6. OzarkHillbilly says:

    @Tsar Nicholas: Shorter Tsar: I am a complete and utter a$$.

    Like or Dislike: Thumb up 4 Thumb down 0

  7. swbarnes2 says:

    @OzarkHillbilly:

    I think the fact that the kid was 30 hours old when treated probably contributed too. Neonates don’t have much of an immune system. Which means it’s not going to be easily translatable into adults

    And I’m no HIV expert, but if the HIV sequence is in her cells, I don’t see how you can be sure that it won’t be activated in the future, and go back to making live virus. Lying dormant in the DNA is what HIV does.

    Like or Dislike: Thumb up 3 Thumb down 0

  8. Ben Wolf says:

    @OzarkHillbilly: That was why he wrote it. To get a reaction.

    Like or Dislike: Thumb up 1 Thumb down 0