Doctors announced on Sunday at the 20th Retroviruses and Opportunistic Infections Conference in Atlanta, Ga. that a two-year-old girl born to a Mississippi woman with HIV had been cured.
It's the first case of its kind in the world, and HIV specialists are extremely encouraged by the potential it holds in curing newborns who are infected with the virus by HIV-infected mothers.
Researchers said they believe early intervention in this case within 30 hours of the child's birth with three anti-viral drugs, was key to the outcome.
Specialists call it a functional cure or long-term remission, even though trace amounts of the virus remain in the toddler.
The unidentified girl was born HIV-positive to a mother who received no prenatal care and was not diagnosed as HIV-positive herself until just before delivery in the fall of 2010.
Dr. Hannah Gay, the pediatric HIV specialist at the University of Mississippi Medical Center, said she had to implement a somewhat modified protocol of treatment for the unidentified infant when therapy would have normally been implemented under these circumstances almost immediately after birth.
"This baby was considered high risk for several reasons. First of all, we were unable to treat the mom during pregnancy. Secondly, the baby was born somewhat prematurely. The baby was born by vaginal delivery as opposed to C-section," Gay explained.
Typically in a high risk infant, Gay says the standard HIV drug AZT is given as a precaution even before doctors can make an HIV diagnosis. But having missed that very early window of intervention, she made the decision, a fairly routine one, to move forward with a more aggressive treatment.
"I started more than one drug. I drew tests just as they started those drugs and two different types of tests showed me within the next couple of days that the baby was already infected," Gay said.
After the child responded well through age 18 months, the family temporarily quit returning and stopped treatment, researchers said. When they were tracked down several months later, remarkably, Gay’s standard tests detected no virus in the child’s blood.
Gay said while this development is more than encouraging, prevention is still the best method for infants born to infected mothers. She said the key is treating the pregnant mother and having complete control of the viral load in her body at the end of pregnancy and at delivery.
The case has big implications. While fewer than 130 such children are born each year in the U.S., an estimated 330,000 children around the world get infected with HIV at or around birth every year, most of them in sub-Saharan Africa.
In the U.S., such births are very rare because HIV testing and treatment long have been part of prenatal care.
"We can’t promise to cure babies who are infected. We can promise to prevent the vast majority of transmissions if the moms are tested during every pregnancy,’’ Gay stressed.
Researchers are now trying to figure out if what Gay did can be replicated in other children infected with the virus.