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An AIDS cure reported at U. of Miss. Medical Center

There has been one prior instance of someone cured of AiDS in history, a patient who had a bone marrow transplant.

NPR reports a child who contracted AIDS at or near birth, cured by early and higher doses of antiviral drugs, administered by a University of Mississippi pediatric infectious disease specialist named Hannah Gay (pictured above, from the medical center’s web page).  The development has been described as “exciting” and “definitely a game-changer.”

NPR reports:

Scientists believe a little girl born with HIV has been cured of the infection.

She’s the first child and only the second person in the world known to have been cured since the virus touched off a global pandemic nearly 32 years ago.

Doctors aren’t releasing the child’s name, but we know she was born in Mississippi and is now 2 ½ years old – and healthy. Scientists presented details of the case on Sunday at ascientific conference in Atlanta.

The case has big implications. While fewer than 130 such children are born each year in the U.S., an estimated 330,000 children around the world get infected with HIV at or around birth every year, most of them in sub-Saharan Africa.

And while many countries are striving to prevent these mother-to-child infections, many thousands of children will certainly get infected in coming years.

Until now, such children have been considered permanently infected. Specialists thought they needed lifelong antiviral drugs to prevent HIV from destroying their immune system and killing them of AIDS.

The Mississippi child’s surprising cure came about from happenstance – and the quick thinking “The child came to our attention as a high-risk exposure to maternal HIV,” Gay tells Shots. Her mother hadn’t had any prenatal care, she says, so didn’t get antiviral drugs during pregnancy.

The fact that the newborn tested positive for HIV within 30 hours of birth is a sign she was probably infected in utero, HIV specialists say.

Gay decided to begin treating the child immediately, with the first dose of antivirals given within 31 hours of birth. That’s faster than most infants born with HIV get treated, and specialists think it’s one important factor in the child’s cure.

In addition, Gay gave higher-than-usual, “therapeutic” doses of three powerful HIV drugs rather than the “prophylactic” doses usually given in these circumstances.

Over the months, the baby thrived and standard tests could detect no virus in her blood, which is the normal result from antiviral treatment.

Then, her mother stopped bringing the child in for checkups.

“The baby’s mom was having some life changes, that’s about all I can say,” Gay reports. “I saw her at 18 months, and then after that did not see her for several months. And we were unable to locate her for a while.”

Gay enlisted the help of Mississippi state health authorities to track down the child. When they found her, the mother said she’d stopped giving antiviral drugs six or seven months earlier.

At that point, Gay expected to find that the child’s blood was teeming with HIV. But to her astonishment, tests couldn’t find any virus.

“My first thought was, ‘Oh my goodness, I’ve been treating a child who’s not actually infected,’ ” Gay says. But a look at the earlier blood work confirmed the child had been infected with HIV at birth. So Gay then thought the lab must have made a mistake with the new blood samples. So she ran those tests again.

“When all those came back negative, I knew something odd was afoot,” Gay says. She contacted an old friend, Dr. Katherine Luzuriaga at the University of Massachusetts, who has been studying pediatric HIV/AIDS for two decades.

That was last August. Since then, Luzuriaga’s lab and those in San Diego, Baltimore andBethesda, Md., have run ultra-sensitive tests on the baby’s blood.

A couple of tests have intermittently found pieces of HIV DNA and RNA, but no evidence that the virus is actively replicating in the child’s cells.

Luzuriaga tells Shots this amounts to what’s called a “functional cure.”

She says that “means control of viral replication and lack of rebound once they come off anti-retroviral medications.”

The only other such case known to AIDS researchers is the so-called Berlin patient – a San Francisco man named Timothy Brown. But his treatment involved a bone marrow transplant in Germany – essentially, he was given the immune system of a donor who’s genetically resistant to HIV. That’s not something that can be easily duplicated.

By contrast, the Mississippi child’s cure involved readily available medications.

Luzuriaga says researchers believe they have ruled out other possible reasons for the unexpected cure. For instance, the mother did not have a less virulent strain of HIV. And the child does not have known mutations in her immunity genes that confer protection against HIV.

“We think it was that very early and aggressive treatment,” she says, “that curtailed the formation of viral reservoirs” – that is, hideouts for the virus within the child’s immune cells.

Previous research indicates that once these hideouts are established, it can take 70 yearsor more of steady, three-drug antiviral treatment to eliminate them.

Luzuriaga says the toddler’s cure has electrified researchers searching for an HIV cure.

“It’s exciting to us,” she says. “Because if we were able to replicate this, I think it would be very good news.”

Dr. Deborah Persaud of Johns Hopkins University Medical School, who presented the case at the Congress on Retroviruses and Opportunistic Infections, calls the Mississippi cure “definitely a game-changer.”

“This case is sort of the inspiration and provides the rationale to really move forward,” Persaud tells Shots.

Kevin Robert Frost of the Foundation for AIDS Research, or amfAR, agrees that the finding will stimulate a lot of further work. The group helped fund studies to determine if the Mississippi toddler is really cured.

“If this approach is proven effective, we could dramatically change the way children born with HIV are treated,” he tells Shots.

Plans are under way to mount studies to see if early, aggressive treatment can cure other children of HIV. But Persaud says it will be a while before researchers can figure out when it might be safe to stop antiviral drugs deliberately.

This research will undboubtedly be high-priority, given the birth of nearly 1,000 HIV-infected newborns a day in the developing world.

AIDS researchers foresee a day when the same treatment could give many of these children a lifetime free of toxic and costly antiviral drugs.

The New York Times has a story, too.

27 comments to An AIDS cure reported at U. of Miss. Medical Center

  • someoneinnorthms

    I truly believe that the world’s problems should be entrusted to Mississippians. Collectively, we do a horrible job of governing ourselves and educating our children and such. But, there is just something about the individual initiative displayed in Mississippi that convinces me that our people are good. Congratulations to the baby and to the doctor and to anyone who had anything to do with this exciting development!

  • WantedToBeALawyer

    SNM, we Mississippians have the enormous capability of doing good things and the absolutely despicable capability of doing awful things.

    We should all pray that our fellow citizens demonstrate the former.

    PS – I lost ten bucks, betting UM would beat MSU by 20 points in basketball. WTF Ole Miss? (I’m a State fan)

  • NMC

    Well, I agree about the WTF about that game, WTBAL, although, having listened to the South Carolina game, would have counseled against your bet.

  • JL

    I am surprised that this case esp. being the first example of a cure has been given so much press. I would think that the process would need to be tested and proved before UMC could say that there is a cure.

  • Terminator

    They aren’t claiming its a cure; in fact, they’re saying it needs to be replicated as the next step. The child was a newborn when they did this, its about 30 months old now.

  • Ben

    WTBAL: Do you need further proof that college basketball has been “touched” by gambling? The game is headed toward a big implosion.

  • NMC

    They are using the word cure. The NY Times lede: “Doctors announced on Sunday that a baby had been cured of an H.I.V. infection for the first time, a startling development that could change how infected newborns are treated and sharply reduce the number of children living with the virus that causes AIDS.”

    From later in the story: “If the report is confirmed, the child born in Mississippi would be only the second well-documented case of a cure in the world. ” Later: ““For pediatrics, this is our Timothy Brown,” said Dr. Deborah Persaud, associate professor at the Johns Hopkins Children’s Center and lead author of the report on the baby. “It’s proof of principle that we can cure H.I.V. infection if we can replicate this case.”

    The word cure crops up (describing what happened) a number of times in both stories.

  • Terminator

    Your last quote makes it clear they aren’t claiming it is a “cure” at this point, especially “…IF we can replicate this case.” Who cares how many times some reporter or blogger used the word “cure” in a story. The fact that one child has apparently been cured is not causing the doctors to claim they have a consistent, proven, cure.

  • Must say, any journalistic report of a scientific or medical discovery should be taken with about enough salt to induce hypertension.

  • Hootie Dasher

    Does anyone recall the Faulkner quote about Mississippians being compared to the Irish. Something about whiskey and literature and pound-for-pound more genius than anywhere else? if someone recalls it, i would appreciate seeing it.

  • RazorRedux

    Hootie,are you referencing the “Herd Theory of Drinking”?http://io9.com/5812892/where-the-buffalo-theory-gets-neuroscience-right-almost
    I’ve seen it in action, I think.

  • Ben

    Calling it an “AIDS cure” is overreaching. I believe the doctors eliminated the HIV virus from the child’s system. Medical people state that there’s a big difference. Regardless … it sounds like badly-needed progress, for which I am grateful.

  • Terminator

    NMC riddled his article and comments with errors. Of course, there was never any announcment of any “cure” for HIV, and certainly not AIDS which are not the same thing. The statement from Johns Hopkins specifically stated that more research is needed to determine whether this child is a highly unusual circumstance or whether the same results can be replicated in other children. Dr. Persuad is the doctor making this statement. Indeed, this event could merely be the equivalent of the only other known “cure” of HIV, the man that had a bone marrow transplant in Germany.

  • Skeptics said that this story of the cure child is not really conclusive. They say that the girl – although at high risk for contracting the virus from her mother – was not actually infected herself. This story shows no proof that the baby girl was indeed born with the virus. On the other hand it mentions that the baby, being at high risk of infection, was placed on treatment even before laboratory investigations had been done. That being said, doctors agree that the child was most likely infected, so it remains a story of hope :)

  • NotZachScruggs

    Any chance of a cure for the brand of hate that took Marco McMillan’s life in Clarksdale?

  • Observer

    Any chance of a cure for the brand of hate that took Marco McMillan’s life in Clarksdale?

    WTF? Do you have ANY evidence that that was a “hate” crime?

    Every killing of a gay person IS NOT a hate crime. Some are simply crimes. Maybe his own lover killed him. Maybe his lover’s jealous boyfriend killed him.

    But let’s not wait on facts before we brand such incidents as hate crimes. No, sir. Let’s not wait on the facts. Let’s smear Richard Jewell. Let’s smear Gary Condit. Let’s hang the Duke Lacrosse team. Let’s hang George Zimmerman.

  • Well, *somebody* hated the poor guy pretty badly.

    But you give the game away when you list Zimmerman amongst the acquitted. In your own mind, evidently, but I’m waiting to hear what the jury says.

  • P.B. Pike

    Observer, you left out your favorite, Sandra Fluke.

  • Ben

    It must be miserable going through life like that ….

  • Observer

    But you give the game away when you list Zimmerman amongst the acquitted. In your own mind, evidently, but I’m waiting to hear what the jury says.

    No, you’re not waiting to see what the jury says. That is obvious by your comment “you gave the game away.” The common thread among the names I listed was that they were all “convicted” by the media overnight, long before any facts were known, and certainly long before there was a trial, but you don’t have the intellect to recognize that.

    Your comment proves my point – you’ve rushed to judgment based upon your own opinion and bias. Facts be damned.

    Meanwhile, in Clarksdale, the news reports are that it was NOT a hate crime.

  • Observer, wipe the spittle off your monitor so you can “observe” well enough to use Google. All the people you listed have been cleared, except Zimmerman.

  • NMC

    With some slight hesitancy about stepping in here, I’ve wondered what (other than the fact of the victim being openly gay) had people leap to the conclusion the crime was about that, as opposed to a carjacking, or whatever. I would not be surprised either way, have read some but far from all the media about it, but had seen nothing (other than immediate assumptions in places like Twitter) that supported any particular conclusion.

  • Idk what happened, but black folks turning up dead & burned has a long heritage in this state, no?

  • Back on topic: the use of the word “cure” is confusing some people.

    They didn’t announce “a cure for HIV.”

    What they announced is that they cured a little child with HIV.

    There is a difference between those two applications of the word “cure” that many people seem to be missing.

    Usually, medical people would say something like:

    Step 1. We cured a patient of disease Y with treatment x.

    Then,

    Step 2. We cured a number of patients of disease Y with treatment x.

    Then,

    Step 3.. Perhaps treatment X is a cure for disease Y.

    Right now, we are step 1.

    John Pittman Hey

  • Observer

    Observer, wipe the spittle off your monitor so you can “observe” well enough to use Google. All the people you listed have been cleared, except Zimmerman.

    How, and when, exactly was Gary Condit “cleared” ? Richard Jewell was merely told he was no longer a “target” of an investigation. Only the Duke Lacrosse team ever got anything close to an exhoneration.

    Some of you are still missing the point. The point is that some jackasses on this blog called the murder of Marco McMillian a “hate” crime — when there’s no evidence and no suggestion that it was. Then there was the snarky comment about it being linked to Section 5, when Coahoma County is a black majority county that has many black elected officials, including its Sheriff. You people are oblivious to how much you embarrass yourselves. If some of you people had the intellect you believe you have, you might be able to color inside the lines.

    BACK TO THE HIV baby, the part of the story that is not getting enough attention is that what Dr. Gay did was fairly courageous — she broke medical protocol and aggressively treated the baby with antiretroviral drugs within 30 hours of birth. That took some guts on the part of the doctor.

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