Dinner Table Science: Positive Negatives: A second case of ‘cured’ HIV reported
Just about a year ago, in early March 2013, one little girl made a big splash in the world of medical research when she became the first child (and the second person) to be cured of HIV. I wrote a blog post about HIV, clearing up some common myths, and about how the reported cure really worked. (You can see my first post and get all the background knowledge at www.dinnertablescience.com/sti-game-changer.) Now, 12 months later, scientists are reporting a second child cured of the deadly virus, and they have a lot more information about how the cure works and where research is headed going forward.
Repeating the medical breakthrough is a good sign. It means the first cure wasn’t just a fluke or stroke of luck, and we could be on our way to stopping the AIDS epidemic. The first little girl cured of HIV was infected in utero, by her mother. She was put on antivirals within 48 hours of being born, which is much sooner than babies are normally medicated, and treatment continued monthly through the first 18 months of her life.
When her mother stopped bringing her to check ups and her treatment ceased, medical professionals assumed that the virus would begin to take over her body, and she’d suffer from HIV despite their early treatment. However, when her mother did bring her back at the age of 2.5, her HIV tests came back negative. Today she’s 3.5, still HIV negative and functionally cured.
Scientists can’t use the words HIV free or cured because HIV is a virus. Viruses live within the body in little clusters of cells. They are very difficult to detect and kill. It’s likely that this little girl still has HIV virus cells in her body, but as of now, they still haven’t multiplied enough to yield positive test results, and her own immune system is keeping them in check. Children respond differently than adults do to HIV–especially young ones. In a newborn baby with HIV, the viruses haven’t set up solid hideouts of cells yet and so the virus is more vulnerable to treatment. This means curing children born with HIV might be the first step to stopping this disease’s spread.
The second baby cured of HIV was born last April (but her test results were just announced to the media last week on March 6) to a mother who had AIDS and had stopped taking her medication. This made the chance of infecting her newborn daughter very high and gave doctors reason to start treatment on this second little girl even earlier than the first–within four hours of her birth. With high levels of antivirals and a careful watch, doctors announced that her virus was undetectable within 11 days of starting treatment.
Doctors say the girl’s condition already looks different than a patient whose virus is simply being suppressed by successful treatment. The child is now about nine months old, and her test results are still negative for HIV. She still receives antiviral treatment–doctors don’t want to risk letting the virus get a good grasp in her body–so she can’t be considered even functionally cured, since she hasn’t been off the medication yet.
The cure for HIV and AIDS may really be well within our sights, only 30 years after the disease was discovered in 1981. In a couple of months, doctors hope to start a clinical trial with babies who are born infected with HIV to test the efficiency of different drug combinations, dosages and also to implement specific protocol to stop and restart antiviral medications. Eventually, curing babies of HIV will be a common practice, once doctors can be sure of what dosage, aggressiveness and duration of treatment is appropriate.
According to the Centers for Disease Control, 127 children were diagnosed with HIV caused by mother-to-fetus transmission in the United States alone in 2011. That number is low because not all cases of HIV are detected that early–some children live for years without showing symptoms or being diagnosed. In fact, the more common the HIV cure becomes, the easier it becomes for doctors to implement it in other countries where mothers are more likely to be HIV positive and where medical treatment is less likely to prevent mother-to-fetus transmission.
These next few months will be crucial–if doctors can nail down the procedure for treating infants for HIV, just think of how many people will grow up to be healthy instead of with a risk of developing AIDS! These children can grow up and live on knowing that they act as a point where HIV transmission was stopped in its tracks. If that isn’t a happy ending, I don’t know what is.