A Mississippi child born with HIV has been in remission for 18 months, a sign that the virus is gone for good.
The case, presented in March, has recently been updated in the New England Journal of Medicine, which confirms the 3-year-old was infected in the womb, and after aggressive treatment shows no signs of infection.
"Our findings suggest that this child's remission is not a mere fluke but the likely result of aggressive and very early therapy that may have prevented the virus from taking a hold in the child's immune cells," Deborah Persaud, M.D., lead author of the NEJM report and a virologist and pediatric HIV expert at the Johns Hopkins Children's Center, said in a statement.
Doctors who identified the infection and treated the child continue to monitor her. According to the report, the baby was born to an HIV-infected mother and began anti-retroviral treatment 30 hours after birth. Tests showed the virus began to diminish and reached undetectable levels in 29 days. The child stayed on anti-retroviral treatment until she was 18 months old. About 10 months after treatment stopped, tests show so signs of the virus in her blood.
"We're thrilled that the child remains off medication and has no detectable virus replicating," pediatrician Hannah Gay, M.D., of the University of Mississippi Medical Center, said. “There is no sign of the return of HIV, and we will continue to follow her for the long term."
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Doctors say there is no clear-cut definition of a cure for HIV, and suggest only time will tell if the child will be cleared of the virus for good.
"At minimum, the baby is in a clear remission. It is possible that the baby has actually been cured. We don't have a definition for cure as we do for certain cancers, where after five years or so you can be relatively certain the person is not going to go and relapse," Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the Associated Press.
The case has led to a new federally funded study set to begin in 2014 involving the same treatment methods used on the child to see if they can treat all HIV-infected newborns in the future. Doctors plan on giving medication to HIV-infected children for at least two years and watch for signs of remission, according to AP.
"Prompt antiviral therapy in newborns that begins within hours or days of exposure may help infants clear the virus and achieve long-term remission without the need for lifelong treatment by preventing such viral hideouts from forming in the first place," Persaud explained.
There has been only one documented case of an individual “cured” from AIDS. Timothy Brown, who was diagnosed with HIV in 1995, shows no signs of the virus six years after receiving a stem cell transplant from a donor immune to the virus. The transplant was triggered after Brown received another devastating diagnosis of acute myeloid leukemia.
“It’s an incredible feeling – like a miracle,” he said. “I had two lethal diseases and was able to get rid of both of them.”
The Mississippi case may offer a preliminary approach to treating mother-to-child transmission, but doctors say it "did open people's eyes further" about a cure for the virus that affects 3.3 million children worldwide.
"We might be able to intervene early and spare children a lifetime of therapy,” Dr. Katherine Luzuriaga, a University of Massachusetts AIDS expert involved in the baby's care, told the AP. “That is the potential impact of this case."