The science and medical communities are rallying around the case of a child born with, and apparently cured of, HIV. The case was presented at the Conference on Retroviruses and Opportunistic Infections on Sunday, revealing that a baby born in 2010 appears to be AIDS free thanks to aggressive treatment of the virus during the first days of its life. If the findings hold up, and scientists and doctors can determine exactly why the treatment was effective, the case could lead to cures for newborn babies infected with HIV in the future.
The New York Times explains that the baby's treatment at a Mississippi hospital was unusual; normally, in the United States, mothers are treated for HIV during pregnancy and don't transfer the infection to their babies. But in this case, the mother arrived already in labor, having never visited a doctor during her pregnancy and unaware that she was infected with HIV.
Dr. Hannah Gay at the University of Mississippi Medical Center tested the baby's RNA and DNA and found a concentration of the virus that indicated infection had occurred in the womb. This is where the baby's case stands out, according to the Times:
"Typically a newborn with an infected mother would be given one or two drugs as a prophylactic measure. But Dr. Gay said that based on her experience, she almost immediately used a three-drug regimen aimed at treatment, not prophylaxis, not even waiting for the test results confirming infection.
Virus levels rapidly declined with treatment and were undetectable by the time the baby was a month old. That remained the case until the baby was 18 months old, after which the mother stopped coming to the hospital and stopped giving the drugs.
When the mother and child returned five months later, Dr. Gay expected to see high viral loads in the baby. But the tests were negative.
Suspecting a laboratory error, she ordered more tests. 'To my greater surprise, all of these came back negative,' Dr. Gay said."
Some scientists speculate that the aggressive treatment killed off the HIV before it was able to create "reservoirs" in the baby's body. As AIDS Research.org elaborates: "HIV is able to remain a chronic, life-long infection due to its ability to stay hidden within infected blood cells. These cellular “reservoirs” contain the genetic code of HIV. They remain invisible to our body’s immune defenses, and are not sensitive to anti-HIV drugs."
There's naturally some skepticism around the case. Some experts aren't convinced the baby was actually infected, saying the drugs could have merely prevented the baby from contracting HIV. Others point out that a true "cure" would be able to eradicate HIV reservoirs. Nevertheless, doctors who worked on the case are adamant the baby was infected and that this was a cure, not preventative treatment. If they can retrace their steps, they may one day be able to offer treatment to thousands of babies born with HIV every year; 330,000 were infected in 2011, according to the United Nations.
While the medical community has focused on preventative medicine rather than cures, this treatment is dramatically easier than the bone marrow transplant that seemingly cured a man named Timothy Brown several years ago. Brown, being treated for leukemia, had two bone marrow transplants from a donor naturally resistant to HIV. That's not a realistic path to a cure--bone marrow transpants are both expensive and taxing on the body, and the Times writes that "the donor was among the 1 percent of Northern Europeans naturally resistant to H.I.V. infection because they lack CCR5, a protein on the surface of immune cells that the virus uses as an entry portal."
It's more likely a true cure will come from genetically modifying immune cells to remove CCR5. That research marches on. More recently, Spanish scientists have developed a vaccine that temporarily halts growth of HIV in the body, though it loses effectiveness after a year. But if the Mississippi baby's treatment proves effective in other cases, we can hope to see HIV cases in newborns drop worldwide in the coming years.