Baby cured of HIV, but little impact expected on SA policy
An American baby has been cured of HIV, but it will have little effect on South Africa’s health policy where mother to child transmission of HIV continues to plummet.
The baby girl was born in 2010 to an HIV positive to a Mississippi mother, who was only diagnosed HIV+ just before giving birth, the Conference on Retroviruses and Opportunistic Infections in Atlanta was told yesterday.
As the mother had not received prevention of mother to child anti-retroviral therapy, the baby's doctor Hannah Gay, from the University of Mississippi, put the infant on triple dose ARV therapy.
This is a combination of three different anti-retrovirals.
The baby was treated when it was only 30 hours old and remained on ARVs until she was 18 months old.
When the doctor retested the child at the age of two, she tested negative.
The little girl’s viral load for HIV has remained undetectable for the past six months, meaning the HIV virus is not replicating, even though the toddler is not on medication.
This is known as a functional cure.
Dr Francesca Conradie, president of the HIV Clinicians Society in South Africa, said: “What the cure of the baby shows us is that if the HI virus is stopped through medication before getting into a person’s genes, a person can be cured”.
But this cannot be done with adults, as it is not possible to know when exactly an adult becomes infected with HIV and then treat them immediately afterwards, she said.
Paediatric and adolescent HIV researcher Dr Harry Moultrie from the Wits Reproductive Health and HIV Research Institute said, “It tells us it is possible to achieve a functional cure. However there are a lot of questions that remain”.
He said scientists needed to be able to replicate the study results in other instances. “If we repeated the intervention with 100 newborn infants who tested positive, would the result be the same?” he asked “So far, it is only one child.”
Moultrie said the study results needed to be generalised to other regions such as South Africa where baby's genes and the virus were slightly different.
He added that the study would not impact on policy in South Africa in which each year, only 13 000 , babies are born positive thanks to South Africa's prevention of mother-to-child programme.
HIV positive pregnant women are given anti-retrovirals and a new born baby is given nevirapine. Conradie said this was the best way to keep babies HIV negative.
The mother to child transmission rate of HIV is now at 2.7%m meaning less than 3% all babies born to positive mothers present as HIV positive in South Africa. This is down from the rate of 8% in 2010.
Moultrie said the study results should keep funders and researchers looking for a functional cure for Aids. "A cure must be the focus," he said.
The Wits Reproductive Health and HIV Research Institute Pediatrician Lee Fairlie heard the conference paper presented at the CROI conference in Atlanta. She the study was met with "excitement and caution".
"It is still only one case and a lot more research is needed.''
She encouraged all mothers to keep HIV positive infants and toddlers on treatment.