Researchers say they have, for the first time, cured a baby born with HIV - a
development that could help improve treatment of babies infected at birth. There is an important technical nuance: researchers insist on calling it a
"functional cure" rather than a complete cure.
That is because the virus is not totally eradicated. Still, its presence is
reduced to such a low level that a body can control it without the need for
standard drug treatment.
But in this new case, the baby girl received nothing more invasive or complex
than commonly available antiretroviral drugs. The difference, however, was the
dosage and the timing: starting less than 30 hours after her birth.
How the tests were done
The baby was infected by her HIV-positive mother, and her treatment with
therapeutic doses of antiretroviral drugs began even before her own positive
blood test came back.
The typical protocol for high-risk newborns is to give them smaller doses of
the drugs until results from an HIV blood test is available at six weeks
Tests showed the baby's viral count steadily declined until it could not
longer be detected 29 days after her birth.
The child was given follow-up treatment with antiretrovirals until 18 months,
at which point doctors lost contact with her for 10 months. During that period
she was not taking antiretrovirals.
Researchers then were able to do a series of blood tests - and none gave an
Natural viral suppression without treatment is an exceedingly rare
occurrence, seen in fewer than half a percent of HIV-infected adults, known as
"elite controllers," whose immune systems are able to rein in viral replication
and keep the virus at clinically undetectable levels.
A game changer
Experts on HIV have long wanted to help all HIV patients achieve
elite-controller status. Researchers say this new case offers hope as a
game-changer, because it suggests prompt antiretroviral therapy in newborns
indeed can do that.
Still, they said, their first priority is learning how to stop transmission
of the virus from mother to newborn. ARV treatments of mothers currently stop
transmission to newborns in 98% of cases, they say.
It is that kind of aggressive treatment that likely yielded the "functional
cure," researchers reported.
What researchers call dormant HIV-infected cells often re-start infections in
HIV-infected patients within a few weeks after antiretroviral treatment stops,
forcing most people who have tested HIV-positive to stay on the drugs for life
or risk the illness progressing.
"Prompt antiviral therapy in newborns that begins within days of exposure may
help infants clear the virus and achieve long-term remission without lifelong
treatment by preventing such viral hideouts from forming in the first place,"
said lead researcher Deborah Persaud, of Johns Hopkins Children's Center in
It appears to be the first time this was achieved in a baby, she said."Our next step is to find out if this is a highly unusual response to very
early antiretroviral therapy or something we can actually replicate in other
high-risk newborns," Persaud pointed out.
The research was funded by the National Institutes of Health and the American
Foundation for AIDS Research.