The child (no identifiable data provided) who is now two years old, has been off HIV medication for 10 months and has tested negative for detectable levels of HIV using conventional testing methods. This is the first case like it and they still have to conduct further tests to see if they could replicate their actions, but luckily the entire procedure was well-documented since the child’s birth.
Back in 2010, the child was born prematurely in Mississippi at 35 weeks, to an HIV infected mother who had no idea she was carrying the virus. While HIV transmission from mother to child is usually very low, this infant was unlucky and contracted the virus. Polymerase chain reaction (PCR) testing was used to test two separate blood samples, both confirming that the HIV virus had transferred to the infant.
At the age of 30 hours, the baby was started on a liquid antiretroviral treatment consisting of a combination of three anti-HIV drugs: zidovudine, lamivudine, and nevirapine. At one week of age, the baby was then put on liquid antiretroviral therapy consisting of combination zidovudine, lamivudine and co-formulated lopinavir-ritonavir. This drug combination is a standard regimen for treating HIV-infected infants in the United States.
Additional plasma viral load tests performed on blood from the baby over the first three weeks of life again indicated HIV infection. However, by Day 29, the infant’s viral load had fallen to less than 50 copies of HIV per milliliter of blood (copies/mL).
The baby remained on the prescribed antiretroviral treatment regimen until 18 months of age (January 2012), when treatment was discontinued for reasons that are unclear. However, when the child was again seen by medical professionals in the fall of 2012, blood samples revealed undetectable HIV levels (less than 20 copies/mL) and no HIV-specific antibodies. Using ultrasensitive viral RNA and DNA tests, the researchers found extremely low viral levels.
Today, the child continues to thrive without antiretroviral therapy and has no identifiable levels of HIV in the body using standard assays. The child is under the medical care of Hannah Gay, M.D., a pediatric HIV specialist at the University of Mississippi Medical Center in Jackson. Researchers will continue to follow the case.
The case was presented at the Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta by Deborah Persaud, M.D. associate professor of infectious diseases at the Johns Hopkins Children’s Center in Baltimore, and Katherine Luzuriaga, M.D., professor of pediatrics and molecular medicine at the University of Massachusetts Medical School in Worcester.
“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,” said Dr. Persaud.
[Cover Photo: National Institutes of Health]