Question
Is it true that a baby has been cured of HIV?
11 March 2013. Related: All topics, Children, Cure, Pregnancy.
Last week’s news reports across the world included the incredible information that a baby had been cured of HIV. Is this really true?
Answer
This news about this case was presented at an HIV medical conference (Conference on Retroviruses and Opportunistic Infections) in Atlanta on 4th March 2013.
Researchers reported that a 26-month old child no longer has detectable virus (using standard tests) after five months off treatment. The child had been born with HIV and given antiretroviral drugs from when she was 30 hours old for about 18 months,
But although the researchers could still detect HIV at very low levels, this was close to the levels of sensitivity for the test. This means the child may not have been completely cured of HIV but this is what is called a “functional cure”. This means that she may still be infected but does not require treatment at the moment. It is not known whether her HIV might become detectable and she will need treatment in the future.
So how did this happen?
It is uncommon for babies to be born with HIV in Europe or America (where the child lives). This is because mothers are usually tested for HIV in pregnancy and treated with antiretrovirals if they are positive.
In this case, the mother’s HIV status was not discovered in time to give her antiretroviral treatment (ART) when she was still pregnant. HIV tests on the baby when she was two days old confirmed that she was also infected.
The baby was immediately given ART using nevirapine, AZT and 3TC. She was tested (viral load test) at seven, 12 and 20 days after starting treatment and all these tests showed she had detectable virus. But when she was tested at 29 days she had an undetectable viral load. This continued to be undetectable until she was 18 months old.
Then the mother and child did not come back to the clinic for five months. When they returned to the clinic and the child was tested again, her doctors were surprised to find that her viral load was still undetectable. This was despite not having been taking ART.
The child was then tested with very sensitive tests. Some of these tests found tiny amounts of HIV but these viral particles were not able to replicate. This may mean that the baby is not infectious.
The child has now been off treatment for a year and her viral load continues to be undetectable.
Now researchers will look at whether a functional cure is possible for other babies in the same situation. This could lead to important new strategies for mothers and babies, particularly in poor countries where the majority of vertical transmissions take place.
Further reading
For more information about this baby, see TAG’s Richard Jefferys has an excellent blog and has described this case in detail. He also regularly reports on other cure and basic science research.
The presentation is online (it is the seventh presentation in the session “Is there hope for HIV eradication”).
Hi Greg,
Probably not, because in this instance treatment was given before HIV infection was fully established. In chronically infected people there are ‘viral reservoirs’ – areas where HIV is stored in sleeping cells, which are unable to be targeted with current HIV treatment. Please follow the links above for further information, and also see this article in the Wall Street Journal which answers this and other questions about this case.
Is this discovery likely to be meaningful for people with already chronic infection?