Following reports that a baby girl who was born with HIV has been cured after very early standard drug therapy, Dr John Frater from Oxford University explains the implications of this case on HIV treatment.
12:45PM GMT 04 Mar 2013
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When the baby girl was born in a rural hospital, her mother had just tested
positive for HIV infection. Because her mother had not received any prenatal
HIV treatment, doctors knew the child was born at high risk of being
infected. So they transferred the baby to the University of Mississippi
Medical Center in Jackson, where she came under the care of Dr Hannah Gay, a
pediatric HIV specialist.
Because of her high infection risk, Dr Gay put the infant on a cocktail of
three standard HIV-fighting drugs when she was just 30 hours old, even
before lab tests came back confirming her infection. In more typical
pregnancies when an HIV-infected mother has been given drugs to reduce the
risk of transmission to her child, the baby would only have been given a
single drug to reduce her infection risk.
Researchers believe this early use of antiviral
treatment likely resulted in the infant's cure by keeping the virus
from forming hard-to-treat pools of cells known as viral reservoirs, which
lie dormant and out of the reach of standard medications. These reservoirs
rekindle HIV infection in patients who stop therapy, and they are the reason
most HIV-infected individuals need lifelong treatment to keep the infection
at bay.
After starting on treatment, the baby's immune system responded and tests
showed levels of the virus were diminishing until it was undetectable 29
days after birth.
"This case starts to make the research community, clinicians and patients
think that hopefully in the future, a cure for HIV is something that might
be a realistic goal," says Dr
John Frater from the Nuffield Department of Medicine at Oxford
University.
