A team of American virologists on Sunday announced the first case of functional recovery of a child infected at birth with the AIDS virus (HIV) transmitted by his mother. The child was off medication for the past year.
It is not an eradication of the virus but that its presence is so low that the body’s immune system can control it without antiretroviral (ART) therapy, explained the virologists.
The only complete cure officially recognized in the world is that of the American Timothy Brown. He was declared cured after a bone marrow transplant from a donor with a rare genetic mutation preventing the virus from entering cells. This graft was designed to treat leukemia.
In the case of the child, he can now control the infection without treatment he had received antiretroviral less than 30 hours after the birth.
This early treatment probably explains his functional recovery by blocking the formation of viral reservoirs which are difficult to treat, according to researchers who presented the case to the 20th Annual Conference on Retroviruses and Opportunistic Infections (CROI) held this weekend in Atlanta.
“Those so-called reservoirs of dormant cells usually rapidly re-infect anyone who stops medication,” said Dr. Deborah Persaud a virologist at Children’s Centre, Faculty of Johns Hopkins University Hospital in Baltimore, lead author of the clinical study.
“An early antiretroviral therapy in newborns may enable getting a very long remission without antiretrovirals preventing the formation of these viral hidden reservoirs,” added Dr. Persaud,.
This is apparently what happened with this child, this researcher believes. Tests showed a gradual decrease in the presence of virus in the blood of the newborn until the virus is undetectable 29 days after birth. The child was treated with ART up to 18 months of age, at which doctors have lost track of him for ten months. During this period he had no ART treatment. The doctors then conducted a series of blood tests, none of which has detected the presence of HIV in the blood.
Suppression of HIV viral load without treatment is extremely rare, being observed in less than 0,5 percent of infected adults whose immune system prevented replication of the virus and made it clinically undetectable, said the virologists. According to them, this case could change current medical practice by highlighting the potential of antiretroviral therapy soon after the birth of children at high risk.
But these researchers emphasize the primary goal is to prevent transmission from mother to child. Antiretroviral therapy now allow the mother to avoid transmitting the virus to the fetus in 98% of cases, they said. The research was funded by the National Institutes of Health and the American Foundation for AIDS Research.
Reply