A cure for pediatric HIV?

A child born infected with the HIV virus appears to have been cured of the disease, a development that could affect how newborns with the virus are treated.

The surprising announcement of preliminary findings from researchers at Johns Hopkins Children’s Center said that the child, born in Mississippi and now aged 2.5 years and healthy, has been off antiretroviral therapy (ART) for a year and shows no signs of recurrent infection.

The infant was born to an HIV-infected mother and received ART within 30 hours of birth, which researchers say likely halted the formation of dormant cells that cause reinfection in most patients with HIV who stop their medication. Repeat blood testing over the next month showed progressively diminishing virus, and at 29 days after birth the baby was said to be “functionally cured,” meaning that standard clinical testing failed to detect HIV replication in the blood.

The baby was kept on ART until aged 18 months, when the family was lost to follow-up and apparently stopped treatment. Ten months later, now aged about 28 months, the child returned and underwent repeated blood tests that detected no HIV or HIV-specific antibodies. Other ultrasensitive tests showed only genetic remnants of viral material that do not appear to replicate.

Researchers caution that they do not have enough data to recommend changing protocols for treating infants born to mothers with HIV-which is currently a combination of antiretrovirals at prophylactic doses for 6 weeks then therapeutic doses if infection is found. However, this new case for early ART may be the catalyst for change because it provides the rationale for starting more studies in high-risk newborns.

If confirmed, the Mississippi child would be only the second case in the world of a patient cured of HIV. The first case was a middle-aged man dying from leukemia and HIV who received a bone marrow transplant from a donor found to be genetically resistant to HIV infection. He recovered and has been virus free for 5 years.