July 11, 2014
Child Believed To Be Cured Of HIV Now Has Detectable Virus Levels
redOrbit Staff & Wire Reports - Your Universe Online
The Mississippi infant believed to have been cured of HIV following an extended remission now once again has “detectable levels” of the AIDS-causing virus in her blood, the US National Institute of Allergy and Infectious Diseases (NIAID) has confirmed.
The child was born prematurely in 2010 to an HIV-infected mother who had not been diagnosed until the time of delivery and had not been given antiretroviral medication during pregnancy. The baby went over two years without requiring treatment or showing any evidence of the virus, according to medical experts involved in the case.
“Certainly, this is a disappointing turn of events for this young child, the medical staff involved in the child’s care, and the HIV/AIDS research community,” explained NIAID Director Dr. Anthony S. Fauci. “Scientifically, this development reminds us that we still have much more to learn about the intricacies of HIV infection and where the virus hides in the body. The NIH remains committed to moving forward with research on a cure for HIV infection.”
The day after being born, the child was diagnosed with HIV and was immediately administered antiretroviral therapy (ART). However, 18 months later, doctors stopped giving her the antiretrovirals. Five months later, the baby underwent a battery of highly sensitive tests that revealed that there was no sign of the virus in her body.
Dr. Deborah Persaud of Johns Hopkins University and her colleagues initially revealed the stunning news at the 2013 Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta, Georgia that March. More than six months later, in October, the same team of experts conducted another follow-up examination and reported that the youngster was still free of active HIV infection 18 months after all treatment was terminated.
Unfortunately, as Reuters reported on July 10, the now four-year-old child known as the “Mississippi Baby” is no longer in remission. The discovery was made during a routine clinical care visit earlier this month, when HIV levels of 16,750 copies/mL were detected in her blood. Repeat viral load blood testing performed 72 hours later confirmed the result (10,564 copies/mL of virus).
In addition, doctors discovered HIV antibodies (indicators of an actively replicating pool of virus in the body) and found that the child had decreased levels of CD4+ T-cells (an essential component of a normally functioning immune system). She is once again receiving antiretroviral therapy, and is said to be tolerating the medication without any side effects to date. Thus far, the treatment has successfully been decreasing her virus levels.
“It felt like a punch to the gut,” Dr. Hannah Gay, a pediatric HIV specialist at the University of Mississippi Medical Center who was involved in treating the girl, told CNN’s Saundra Young and Jacque Wilson. “It was extremely disappointing from both the scientific standpoint… but mainly for the sake of the child who is back on medicine and expected to stay on medicine for a very long time.”
Based on the child’s initial success, doctors had been considering using early and aggressive treatment in infant HIV cases such as this, then stopping medication after two years if there were no signs of infection at that time, according to Associated Press (AP) Chief Medical Writer Marilynn Marchione. In light of today’s news, Fauci said that officials were planning to evaluate whether or not the study would have to be altered in terms of treatment length or potential ethical concerns.
He told the AP that they planned to “take a good hard look at the study and see if it needs any modifications,” and that consent forms needed to participate would have to be revised. He added that the research team is “still very much in the early discovery phase of trying to achieve a sustained virological remission and perhaps even a cure,” and that while there is “much, much more to learn,” he and his colleagues “remain committed to doing so.”
According to USA Today’s Liz Szabo, doctors claim that it is highly unusual for babies in the US to be born with HIV, as women who test positive for the virus are routinely treated with antiretroviral medications. In addition, infants are normally given preventive treatment for the first six weeks of life. Combined, this therapy method has reduced the mother-to-child transmission rate from upwards of 30 percent to less than two percent today.
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