A Cure for HIV in a Newborn?

The case of a Mississippi child “cured” of HIV is a highlight of the 2013 Conference on Retroviruses and Opportunistic Infections.

The situation is unique because the baby received three high-dose antiretroviral medications starting at 31 hours old, and then fell out of care after several months. At 24 and 26 months, tests showed no detectable HIV in the bloodstream, though it was still present in some cells found in the blood.

Whether the child remains asymptomatic, with no detectable HIV in his blood over the long term, remains to be seen. But in 2009, my colleagues and I published a similar case study of a child who received three HIV medications early in life, then had an undetectable viral load and negative antibody tests for HIV. That patient is now 15 and healthy.

In our case, the patient did not fall out of care and continued on HIV medications despite the undetectable viral load. But like this newer case, my colleagues and I still detected HIV in some cells in the blood.

What does all this mean? In the US, babies born to HIV-positive mothers are much less likely to get infected with the virus. For example, in New York State in 1990, 25 to 40 percent of HIV-infected mothers transmitted HIV to their children, but in 2010, the transmission rate dropped to less than one percent. This dramatic decrease in mother-to-baby HIV transmission is largely due to laws that mandate:

• HIV counseling and testing for all women getting prenatal care in regulated facilities. (1996)

• Routine HIV screening for all infants. (part of the New York State Department of Health’s Newborn Screening Program, 1997)

• Expedited testing for mothers with an undetermined HIV status when they are ready to deliver. (1999)

While such laws helped dramatically decrease mother-to-baby HIV transmission, the incidence of this transmission route is still high in many nations, especially undeveloped countries.

The World Health Organization’s standard of care is to give any baby of an HIV-positive mother one medication to fight the virus (two medications if there is a higher risk of transmission) for the first 28 days. This new study highlights the potential benefits of administering three medications to newborns with HIV-positive mothers. Still, researchers and physicians must weigh the encouraging results of this single case against the potential risks of giving these medications early in life.

This study also helps us understand the role of HIV that “hides out” in the human host in viral reservoirs and provides useful information for future studies, which may then lead to eliminating HIV from patients.

Most importantly, this is only one very interesting case. Continuous monitoring of this child’s health will determine if the HIV that remains in some of his cells becomes active again.

http://www.northshorelij.com/hospitals/location/cart-youth-specialized-care-center-hiv-adolescents

Annals of Allergy, Asthma & Immunology 2009

2 Responses to “A Cure for HIV in a Newborn?”

  1. Tiffany

    Since a small amount is found in some blood cells is there a chance they can pass it along to their partners in the future???

    Reply
  2. David Rosenthal, DO

    Tiffany, its a good question and we really don’t know for certain. If the virus is not replicating then eventually we would expect that the CD4 cells it was hiding out in would die, but its likely that the HIV virus hides out in other reservoirs in the body as well. In general it’s the replicating virus that we worry about, which can be transmitted. Since this is the first reported case of its kind, we simply have to wait for more information before we can fully answer these types of questions.

    Reply

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