Following reports that a baby girl who was born with HIV has been cured after very early standard drug therapy, Dr John Frater from Oxford University explains the implications of this case on HIV treatment.
When the baby girl was born in a rural hospital, her mother had just tested positive for HIV infection. Because her mother had not received any prenatal HIV treatment, doctors knew the child was born at high risk of being infected. So they transferred the baby to the University of Mississippi Medical Center in Jackson, where she came under the care of Dr Hannah Gay, a pediatric HIV specialist.
Because of her high infection risk, Dr Gay put the infant on a cocktail of three standard HIV-fighting drugs when she was just 30 hours old, even before lab tests came back confirming her infection. In more typical pregnancies when an HIV-infected mother has been given drugs to reduce the risk of transmission to her child, the baby would only have been given a single drug to reduce her infection risk.
Researchers believe this early use of antiviral treatment likely resulted in the infant’s cure by keeping the virus from forming hard-to-treat pools of cells known as viral reservoirs, which lie dormant and out of the reach of standard medications. These reservoirs rekindle HIV infection in patients who stop therapy, and they are the reason most HIV-infected individuals need lifelong treatment to keep the infection at bay.
After starting on treatment, the baby’s immune system responded and tests showed levels of the virus were diminishing until it was undetectable 29 days after birth.
“This case starts to make the research community, clinicians and patients think that hopefully in the future, a cure for HIV is something that might be a realistic goal,” says Dr John Frater from the Nuffield Department of Medicine at Oxford University.
“The implications of this are that it tells us that we need to research into cure with stronger funding and greater drive.
“But at clinical level it doesn’t mean patients coming off drugs or anything at the moment.”