In an unprecedented case, doctors in Mississippi believe they have "functionally cured" a toddler of an HIV infection.
Recent tests of a 2-year-old born premature with the disease show no detectable levels of the virus, according to the National Institutes of Health. Doctors credit early administration of antiretroviral therapy for curing the child, who shows no signs of the virus after a year off the drugs.
"Despite the fact that research has given us the tools to prevent mother-to-child transmission of HIV, many infants are unfortunately still born infected," Dr. Anthony S. Fauci, director of National Institute of Allergy and Infectious Diseases, said in a statement today. "With this case, it appears we may have not only a positive outcome for the particular child, but also a promising lead for additional research toward curing other children."
The child was born in Mississippi in July 2010 to an HIV-infected mother who had received neither antiretroviral medication nor prenatal care. The infection was confirmed two days after birth and the child was immediately placed on a liquid antiretroviral treatment consisting of a combination of three anti-HIV drugs: zidovudine, lamivudine, and nevirapine.
Additional blood tests during the child's first three weeks of life also confirmed the presence of the virus. After nearly a month of treatment, the child's viral load had decreased to less than 50 copies of HIV per milliliter of blood.
For reasons that scientists said were unclear, the antiretroviral treatment regimen was discontinued when the child was 18 months old. However, blood tests conducted last fall "revealed undetectable HIV levels (less than 20 copies/mL) and no HIV-specific antibodies," researchers said.
Researchers said it was the first well-documented case of an infected child showing no signs of the disease in the absence of antiretroviral therapy. It's only the second documented case of a person infected with the disease being cured. Timothy Ray Brown, 45, was cured of the disease after receiving a bone marrow stem cell transplant in 2007.
As promising as the results are, the doctors cautioned that additional research was necessary to determine whether the case can be replicated in clinical trials involving HIV-infected children.
"This case suggests that providing antiretroviral therapy within the very first few days of life to infants infected with HIV through their mothers via pregnancy or delivery may prevent HIV from establishing a reservoir, or hiding place, in their bodies and, therefore, achieve a cure for those children," Dr. Deborah Persaud, associate professor of infectious diseases at the Johns Hopkins Children's Center in Baltimore.