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| English: Diagram of the HIV virus. (Photo credit: Wikipedia) |
It seems a cure for HIV/AIDS may not be as distant as it seemed a few years ago...
U.S. Baby’s HIV Infection Cured Through Very Early Treatment
The child’s story is the first account of an infant achieving a
so-called functional cure, a rare event in which a person achieves
remission without the need for drugs and standard blood tests show no
signs that the virus is making copies of itself.
More testing needs to be done to see if the treatment would have the
same effect on other children, but the results could change the way
high-risk babies are treated and possibly lead to a cure for children
with HIV, the virus that causes AIDS.
“This is a proof of concept that HIV can be potentially curable in
infants,” said Dr. Deborah Persaud, a virologist at Johns Hopkins
University in Baltimore, who presented the findings at the Conference on
Retroviruses and Opportunistic Infections in Atlanta.
The child’s story is different from the now famous case of Timothy
Ray Brown, the so-called “Berlin patient,” whose HIV infection was
completely eradicated through an elaborate treatment for leukemia in
2007 that involved the destruction of his immune system and a stem cell
transplant from a donor with a rare genetic mutation that resists HIV
infection.
“We believe this is our Timothy Brown case to spur research interest
toward a cure for HIV infection in children,” Persaud said at a news
conference.
Instead of Brown’s costly treatment, however, the case of the
Mississippi baby, who was not identified, involved the use of a cocktail
of widely available drugs already used to treat HIV infection in
infants.
When the baby girl was born in a rural hospital in July 2010, her
mother had just tested positive for HIV infection. Because her mother
had not received any prenatal HIV treatment, doctors knew the child was
at high risk of infection. They transferred her 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 risk, Dr. Gay put the infant on a cocktail of three
HIV-fighting drugs – zidovudine (also known as AZT), lamivudine, and
nevirapine – when she was just 30 hours old. Two blood tests done within
the first 48 hours of the child’s life confirmed her infection and she
was kept on the full treatment regimen, Persaud told reporters at the
conference.
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, nevirapine.
Researchers believe use of the more aggressive antiretroviral
treatment when the child was just days old likely resulted in her 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.
10-MONTH GAP
After starting on treatment, the baby’s immune system responded and
tests showed diminishing levels of the virus until it was undetectable
29 days after birth. The baby received regular treatment for 18 months,
but then stopped coming to appointments for a period of about 10 months,
when her mother said she was not given any treatment. The doctors did
not say why the mother stopped coming.
When the child came back under the care of Dr. Gay, she ordered
standard blood tests to see how the child was faring before resuming
antiviral therapy.
What she found was surprising. The first blood test did not turn up
any detectible levels of HIV. Neither did the second. And tests for
HIV-specific antibodies, the standard clinical indicator of HIV
infection, also remained negative.
“At that point, I knew I was dealing with a very unusual case,” Dr. Gay said.
Baffled, Dr. Gay turned to her friend and longtime colleague, Dr.
Katherine Luzuriaga of the University of Massachusetts, and she and
Persaud did a series of sophisticated lab tests on the child’s blood.
The first looked for silent reservoirs of the virus where it remains
dormant but can replicate if activated. That is detected in a type of
immune cell known as a CD4 T-cell. After culturing the child’s cells,
they found no sign of the virus.
Then, the team looked for HIV DNA, which indicates that the virus has
integrated itself into the genetic material of the infected person.
This test turned up such low levels that it was just above the limit of
the test’s ability to detect it.
The third test looked for bits of genetic material known as viral
RNA. They only found a single copy of viral RNA in one of the two tests
they ran.
Because there is no detectible virus in the child’s blood, the team
has advised that she not be given antiretroviral therapy, whose goal is
to block the virus from replicating in the blood. Instead, she will be
monitored closely.
There are no samples that can be used by other researchers to confirm
the findings, which may lead skeptics to challenge how the doctors know
for sure that the child was infected.
Persaud said the team is trying to use the tiny scraps of viral
genetic material they have been able to gather from the child to compare
with the mother’s infection, to confirm that the child’s infection came
from her mother. But, she stressed, the baby had tested positive in two
separate blood tests, and there had been evidence of the virus
replicating in her blood, which are standard methods of confirming HIV
infection.
Source:
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In
keeping with the title ‘UNBREAKABLE” given to him by his visionary
father, the responsibility of manning the family forte fell squarely on
his young shoulders when his father was incarcerated and his beloved
elder brother and lawyer, Segun Awolowo, passed on in 1963. Those were
the difficult times that tried men’s souls; but in spite of the gloom
that enveloped the Awolowo family, he still managed to remain
UNBREAKABLE.
