BOSTON, MASS – The story of the baby born with HIV in Mississippi, treated intensively and immediately, only to be lost to care for five months before turning up healthy, is dominating talk at the Conference on Retroviruses and Opportunistic Infections for a second year, with news that the child continues to show no sign of infectious virus.
The child is nearly three and a half years old now, off treatment for more than two years, and continuing to raise hopes that could change the landscape of pediatric HIV responses.
The first story of the child, told at last year’s CROI “was received with skepticism and optimism,” physician scientist Deborah Persaud, who broke the news of the baby then, acknowledged. In the year since, her laboratory continued to search for signs to confirm that the child was in fact infected with the virus that leads to AIDS and now has no discoverable remaining pool of replicable HIV. The tests being used to search for signs of infection are the same as those used for Timothy Brown, “the Berlin Patient,” who remains the one person considered functionally cured.
While that word remains off-limits for the Mississippi baby, another baby born also is showing promising signs that support the value of early and intensive treatment in newborns, Persaud said. That child, born in Long Beach, California to a mother very sick with HIV and not on treatment, received the same combination antiretroviral drug regimen as the Mississippi baby had received beginning in the first four hours of life, in hopes of duplicating the effect. While that baby remains on antiretroviral treatment, Persaud said, “we’ve been unable to recover infectious virus from this child.” The child, she added, “has become HIV negative.”
All of which feeds both hope and questions, for how to proceed. The effect of early combination treatment, a much higher dosage of medicines than that used for preventive purposes, appears promising, Persaud acknowledged. “We can’t call it a functional cure, but it’s very effective.”
She has heard a series of similar stories since, one just the other day, of five cases in South Africa, three in Canada, in addition to the two here. Trials in which newborns will receive intensive treatment within the first 48 hours of life will follow, she said, through the IMPAACT (International Maternal, Pediatric, Adolescent AIDS Clinical Trials) Network.