Baby Steps: New leads towards an HIV cure

It’s a good month to be an AIDS activist!

After the publication of results pointing to the success of aggressive antiretroviral therapy campaigns in South Africa last week, the light at the end of the tunnel just got a little bit brighter.

Scientists announced on Sunday that a baby born with HIV might have been cured. The child, born in rural Mississippi, is now 2 and a half, and has been off medication for a year with no further sign of infection, AP reported.

Speaking at a press conference at the start of the 20th Conference on Retroviruses and Opportunistic Infection in Atlanta, pediatrician Deborah Persaud called this “the first well-documented case” of its kind, ScienceNOW reported.

Though Persaud did not treat the child herself, she and her colleagues at the Johns Hopkins Bloomberg School of Public Health conducted studies of blood samples, leading her to conclude that early treatment may be the real hero in this case, ScienceNow added.

The baby was treated with antiretroviral drugs starting 30 hours after birth. According to AP, this course of treatment knocked out the HIV in the baby’s blood, before the disease had time to take hold in reservoirs of dormant cells.

This is not something that is usually done, and may cause changes in the ways doctors deal with mother-to-child transmission cases. According to UNAIDS, 330 000 babies were infected in 2011, while more than three million children live with HIV worldwide.

According to The New York Times, if confirmed, this would mark the second case of HIV eradication, the first being Timothy Brown, known as the “Berlin Patient.”

Mother –to-child transmission is of minimal concern in the United States. According to The New York Times, there are only around 200 a year, because mothers are treated during their pregnancies. In Africa however, it remains one of the greatest obstacles to overcome.

Rowena Johnson, research director at amFAR, told The New York Times that though it may be difficult for poorer countries to do, treating at-risk children in a similar way as the Mississippi baby may end up being cost-effective, “sparing the kid a lifetime of antiretroviral therapy.”

Though any reason is good to jump up and down in your seat and watch baby videos on Youtube to celebrate, it may be a little premature. It is unknown whether the child will remain healthy, as scientists reported finding traces of the virus’s genetic material still lingering, AP added.

Some experts remain skeptical, largely because the baby’s HIV status wasn’t definitely confirmed before the drugs were administered, in part because of the late diagnosis of the mother, whose status was only determined during labour, the AP report stated.

The one uncertainty is really definitive evidence that the child was indeed infected,” Dr. Daniel R. Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital in Boston, told The New York Times.

The argument is that this cannot really be counted as a cure if the “reservoirs of infection,” usually responsible for triggering the virus once treatment is stopped, never formed.

Persaud put it another way, telling the AP that the child was “functionally cured,” even if traces of the virus haven’t been completely eradicated.

For Dr. Hannah Gay, an HIV specialist at the University of Mississippi who treats the baby, the situation is much more practical.  For now, she just monitors the baby every few months.

“I just check for the virus and keep praying that it stays gone,” she told AP.

Fingers crossed.

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