Scientists have managed to repeat one of the biggest medical breakthroughs of the last few years.
Almost exactly one year ago, Johns Hopkins researchers made national headlines when they announced that they’ve vanquished the AIDS-causing virus from a child born to an HIV-positive mother in Mississippi. They began antiretroival treatment before the baby was 30 hours old. She’s now 3.5 years old and still virus-free, even without treatment in the last two years. Researchers have puzzled over how it happened, and many remain skeptical. The child was only the second person ever to be “cured” of HIV; the first was an adult through a stem-cell transplant. Since it’s difficult to prove that the body has been completely cleared of HIV, Nature explains, being “functionally cured” means the virus is effectively controlled and the immune system stays healthy without treatment.
Just yesterday, doctors announced that they have cleared the virus from a second baby infected with HIV. This girl was born in Los Angeles last April to a mother with advanced AIDS who had not been taking her medication. With aggressive treatment beginning just four hours after her birth, the virus was undetectable within 11 days, the New York Times reports.
Doctors don’t normally use these sorts of aggressive treatments until they’re sure the baby is infected, and then sometimes not in the first weeks, NY Times explains. “Of course I had worries,” says Audra Deveikis from Miller Children’s Hospital. “But the mother’s disease was not under control, and I had to weigh the risk of transmission against the toxicity of the meds.”
Johns Hopkins’ Deborah Persaud, who led the ultrasensitive testing on both children, says that the Los Angeles baby's signs are different from what doctors see in patients whose infections are merely suppressed by successful treatment. Even though tests suggest the child (now nine months old) has completely cleared the virus, she’s still receiving a 3-drug cocktail -- so using the words “cured” or even “in remission” is wrong, Persaud says.
"Really the only way we can prove that we have accomplished remission in these kids is by taking them off treatment,” Persaud adds, “and that's not without risk.” There might be five more cases of “cured” children in Canada and three in South Africa.
Most HIV-infected moms in the U.S. get medication during pregnancy to cut down the chances of passing the virus on to their babies. A clinical trial scheduled to begin in a couple months will put 60 babies, who are born infected, on drugs within their first two days. “The clinical trial that we’re about to start has specific criteria to stop therapy and to restart it if the virus comes back," says Yvonne Bryson of Mattel Children's Hospital UCLA, who consulted on the Los Angeles baby's care. Results from the trial will help doctors decide when to remove her from treatment.
The findings were announced at the Conference On Retroviruses And Opportunistic Infections in Boston this week.