On Sunday, March 3, a child was deemed functionally cured of an HIV infection. With this landmark case open to greater scrutiny and researchers looking to understand its implications, the door could be open to curing many children who are afflicted with the virus.
The child, born two and a half years ago in rural Mississippi, had contracted the virus, which causes devastating immune disorder AIDS, from its mother. When the signs of the infection were first detected, Dr. Hannah Gay, the presiding physician, immediately (31 hours after birth) put the child on an aggressive antiretroviral treatment regimen. After eighteen months of the treatment, the mother ceased taking the child to the hospital.
Subsequent tests confirmed that the virus was undetectable even after the withdrawal of the drugs. This has never happened before, since in all other reported cases the virus quickly returned once the suppressive effects of the medications were removed. Yet over one year after withdrawing treatment, the virus appears to have vanished.
According to the New York Times report that broke the story, Dr. Deborah Persaud, as associate professor at Johns Hopkins Children’s Center, said, “It’s proof of principle that we can cure HIV infection if we can replicate this case.”
She reiterated to The Wall Street Journal the unprecedented nature of this event: “That’s really unheard of. If people go off therapy, most of them rebound..within a few weeks.”
One reason this might have worked was cited by Dr. Anthony S. Fauci, cited here in the New York Times: “That goes along with the concept that, if you treat before the virus has had an opportunity to establish a large reservoir and before it can destroy the immune system, there’s a chance you can withdraw therapy and have no virus.”
Though children of HIV-positive parents are rigorously tested soon after birth, most adults who contract the virus do not realize it until much later.
While the case has little relevance to older people who are living with an HIV infection or AIDS, the significant number of infants who are born with the disease might glean powerful benefits from this case. Over 300,000 children, 90 percent of them in sub-Saharan Africa, are born having contracted the virus from their mothers, which can occur during pregnancy, birth or breastfeeding. At this point, preventative measures, when properly implemented, have reduced the chances of such transmission to about two percent. While that number is far lower than it once was, that leaves thousands of children with infections who might now have hope for a cure.
As with all discoveries of this nature, however, the scientific and medical communities will need time to discover whether any lessons from this remarkable case can be generalized. That said, it remains a medical breakthrough, what Dr. Yvonne Bryson, chief of global pediatric infectious diseases at UCLA, calls “one of the most exciting things I’ve heard in a long time.”
Cautious optimism may be the best most appropriate posture to take after any seemingly-miraculous case come to light, but there is at least a hopeful sign that children who are born HIV-positive can recover and live a life relatively unaffected by the effects of the virus.
