Doctors at the Johns Hopkins Children’s Center are reporting a “functional cure” of an HIV-infected infant.
The infant, known only to have been born in Mississippi, was given antiretroviral therapy (ART) within 30 hours after its birth. Doctors believe the early treatment may have stopped the HIV virus from forming viral reservoirs that can reignite the infection after treatment ends.
“Prompt antiviral therapy in newborns that begins within days of exposure may help infants clear the virus and achieve long-term remission without lifelong treatment by preventing such viral hideouts from forming in the first place,” said Dr. Deborah Persaud, lead author of a report on the case.
Doctors have declared that the child is “functionally cured,” meaning it will likely not need lifelong treatment to suppress the virus. Standard clinical tests on the child’s blood have not been able to find the presence of HIV. This does not mean, however, that the child is completely rid of the virus.
“Our next step is to find out if this is a highly unusual response to very early antiretroviral therapy or something we can actually replicate in other high-risk newborns,” said Persaud.
The baby had been given antiretroviral treatment since its birth, but missed follow-up treatments after 18 months. Ten months after that, blood tests failed to find the presence of HIV or HIV-specific antibodies.
Researchers believe this case could change the way infants at risk for HIV are treated. Currently, infants born to HIV-positive mothers with poorly controlled infections are given a combination of antiviral and prophylactic medication.
“Complete viral eradication on a large scale is our long-term goal but, for now, remains out of reach, and our best chance may come from aggressive, timely and precisely targeted use of antiviral therapies in high-risk newborns as a way to achieve functional cure,” said Dr. Katherine Luzuriaga, an investigator on the study and an immunologist at the University of Massachusetts Medical School.