'Functional cure' reported in HIV-positive baby
'Functional' cure reported in HIV-positive baby
HealthDay New) -- A premature baby born with HIV and treated very early may represent the first functional cure of HIV. The baby had no detectable virus after being off of antiretroviral medications for more than six months, according to researchers at the 2013 Conference on Retroviruses and Opportunistic Infections.
"This is a very exciting finding. By treating a baby very early [we may be able to] prevent viral reservoirs or cells that stay around for a lifetime of an infected person," researcher Deborah Persaud, MD, of the Johns Hopkins Children's Center in Baltimore said at a press conference.
Usually, babies suspected of being exposed to HIV are treated prophylactically at birth, but wait four to six weeks for tests to confirm their status before starting drug therapy. In this case, the initial and confirming tests were completed within 30 hours of birth, and therapy was initiated after early samples showed HIV viral loads of 20,000 copies/ml.
HIV was still present in five subsequent blood tests, but at day 29 treatment had suppressed the virus to undetectable levels. The child continued therapy and had no detectable virus at age 18 months, but was lost to follow-up.
When the child re-presented at 23 months, the caregiver reported antiretroviral therapy had been discontinued. After testing with a 20 copy/ml assay, viral loads remained undetectable. Further ultrasensitive assays were also employed, but no copies of replication-competent virus could be detected.
"The child (now 30 months old) remains off antiretroviral therapy and remains well," Persaud said.
Although there have been 42 previously documented cases of seroconversion, in a which an HIV-positive infant is later found not to have the virus, all such cases have been due to laboratory errors or misinterpretation of data, the researchers noted.
This case is unique because the child was premature and remained at the hospital for the first few weeks of life. Among baby's born at term, there is a delay from the time when blood is drawn, results are analyzed and confirmed and treatment is initiated, usually about 6 weeks after birth.
The researchers added that the latest findings should be interpreted with caution, as trace amounts of HIV can still be detected in the child's peripheral blood using highly sensitive testing, and the final outcome remains unknown.