WASHINGTON (AP) – A baby born with the virus
that causes AIDS appears to have been cured, scientists announced Sunday,
describing the case of a child from Mississippi
who's now 2 1/2 and has been off medication for about a year with no signs of
infection.
There's no guarantee the child will remain healthy, although sophisticated
testing uncovered just traces of the virus' genetic material still lingering.
If so, it would mark only the world's second reported cure.
Specialists say Sunday's announcement, at a major AIDS meeting in Atlanta, offers promising
clues for efforts to eliminate HIV infection in children, especially in
AIDS-plagued African countries where too many babies are born with the virus.
"You could call this about as close to a cure, if not a cure, that
we've seen," Dr. Anthony Fauci of the National Institutes of Health, who
is familiar with the findings, told The Associated Press.
A doctor gave this baby faster and stronger treatment than is usual,
starting a three-drug infusion within 30 hours of birth. That was before tests
confirmed the infant was infected and not just at risk from a mother whose HIV
wasn't diagnosed until she was in labor.
"I just felt like this baby was at higher-than-normal risk, and
deserved our best shot," Dr. Hannah Gay, a pediatric HIV specialist at the
University of Mississippi, said in an interview.
That fast action apparently knocked out HIV in the baby's blood before it
could form hideouts in the body. Those so-called reservoirs of dormant cells
usually rapidly reinfect anyone who stops medication, said Dr. Deborah Persaud
of Johns Hopkins Children's Center. She led the investigation that deemed the
child "functionally cured," meaning in long-term remission even if
all traces of the virus haven't been completely eradicated.
Next, Persaud's team is planning a study to try to prove that, with more aggressive
treatment of other high-risk babies. "Maybe we'll be able to block this
reservoir seeding," said Persaud.
No one should stop anti-AIDS drugs as a result of this case, Fauci
cautioned.
But "it opens up a lot of doors" to research if other children can
be helped, he said. "It makes perfect sense what happened."
Better than treatment is to prevent babies from being born with HIV in the
first place.
About 300,000 children were born with HIV in 2011, mostly in poor countries
where only about 60 percent of infected pregnant women get treatment that can
keep them from passing the virus to their babies. In the U.S., such
births are very rare because HIV testing and treatment long have been part of
prenatal care.
"We can't promise to cure babies who are infected. We can promise to
prevent the vast majority of transmissions if the moms are tested during every
pregnancy," Gay stressed.
The only other person considered cured of the AIDS virus underwent a very
different and risky kind of treatment -- a bone marrow transplant from a
special donor, one of the rare people who is naturally resistant to HIV.
Timothy Ray Brown of San Francisco
has not needed HIV medications in the five years since that transplant.
The Mississippi
case shows "there may be different cures for different populations of
HIV-infected people," said Dr. Rowena Johnston of amFAR, the Foundation
for AIDS Research. That group funded Persaud's team to explore possible cases
of pediatric cures.
It also suggests that scientists should look back at other children who've
been treated since shortly after birth, including some reports of possible
cures in the late 1990s that were dismissed at the time, said Dr. Steven Deeks
of the University of California, San
Francisco, who also has seen the findings.
"This will likely inspire the field, make people more optimistic that
this is possible," he said.
In the Mississippi
case, the mother had no prenatal care when she came to a rural emergency
room in advanced labor. A rapid test detected HIV. In such cases, doctors
typically give the newborn low-dose medication in hopes of preventing HIV from
taking root. But the small hospital didn't have the proper liquid kind, and
sent the infant to Gay's medical center. She gave the baby higher
treatment-level doses.
The child responded well through age 18 months, when the family temporarily
quit returning and stopped treatment, researchers said. When they returned
several months later, remarkably, Gay's standard tests detected no virus in the
child's blood.
Ten months after treatment stopped, a battery of super-sensitive tests at
half a dozen laboratories found no sign of the virus' return. There were only
some remnants of genetic material that don't appear able to replicate, Persaud
said.
In Mississippi,
Gay gives the child a check-up every few months: "I just check for the
virus and keep praying that it stays gone."
The mother's HIV is being controlled with medication
and she is "quite excited for her child," Gay added.
(Copyright
2013 The Associated Press. All rights reserved. This material may not be
published, broadcast, rewritten or redistributed.)
March 3, 2013: This image provided by Johns Hopkins Medicine shows Dr. Deborah Persaud of Johns Hopkins' Children's Center in Baltimore. (AP/Johns Hopkins Medicine)
