When a baby born HIV positive was reported cured after an aggressive drug treatment administered shortly after her birth, many were skeptical that she had truly had HIV to begin with. However, at an AIDS conference on March 5, a second such case was announced.
At the conference, held in Boston, a leading AIDS researcher said that they were also waiting on confirmation regarding five more cases in Canada and another three in South Africa. Additionally, a clinical trial in which fifty babies born HIV-positive will be given the treatment within forty-eight hours of birth is set to begin by June.
It will take several years of monitoring the babies after treatment to confirm it’s genuinely effective, but if so the medical protocol for treating infants who are born HIV-positive could change relatively soon.
The first baby was born in Mississippi to a mother who had not had any prenatal care and was unaware she was infected until discovered to have an advanced case of AIDS. The baby, whose gender has not been disclosed, was put on a regimen of aggressive antiretroviral drugs about thirty hours after birth for fear that the more usual protocol of prophylactics would be ineffective given the infant’s risk factor.
The second baby thought cured, a girl who was born near Los Angeles in Long Beach, California, is now nine months old and still testing negative for HIV. Doctors at Miller Children’s Hospital in Long Beach knew of the first, and when the child in their care tested positive nine hours after birth, they tried to replicate the first baby’s treatment by giving the antiretroviral drugs AZT, 3TC and nevirapine at levels usually used not for HIV prevention, but treatment. In the past, such high levels were never recommended for newborns.
A virus specialist that assisted in both cases, Dr. Deborah Persaud from the Johns Hopkins Children’s Center, cautioned that calling the second baby cured, or even in remission, is premature, since she remains on antiretroviral drugs as a precaution. The wording Dr. Persaud currently uses is “sero-reverted to H.I.V.-negative.”
The mother of the baby in Mississippi abruptly stopped seeing doctors when the child was eighteen months old, and when they returned the child had not been on antiretroviral medication for five months. Doctors fully expected the toddler’s viral load to be extremely high, but to their shock, even the most sensitive tests detected nothing. The child, who is now three years old, is still virus-free and healthy.
With drug treatment and other precautions such as not breast-feeding, HIV-positive mothers can reduce the risk of their children being born infected to a minimum, leading to very few babies in countries with adequate health care being born with HIV.
However, in the case of the Long Beach mother, Dr. Persaud said that she had not taken the drugs prescribed for her. A blood test when the baby was only hours old showed she was HIV-positive, likely infected in utero rather than during her birth.
Nine months later, even the newest ultrasensitive tests are showing the Long Island baby’s blood and tissues as HIV-free.