Babies born with HIV now have hope because scientists may have found a way to eliminate the virus from their bodies.
A second U.S. baby and five more in Canada have possibly been cured of the virus that leads to AIDS. No traces of the virus have been found in the children's systems after receiving treatment.
"This could lead to major changes for two reasons," says Dr. Anthony S. Fauci, executive director of the National Institute for Allergy and Infectious Diseases. "Both for the welfare of the child and because it is a huge proof of concept that you can cure someone if you can treat them early enough."
The first instance of a cure was found two years ago when a Mississippi baby was diagnosed with the virus. Just 30 hours after birth, the infant was transported to the University of Mississippi Medical Center and was started on antiretroviral treatment. Doctors prescribed three aggressive drugs immediately after birth, which proved to make the difference.
Initial levels of the virus were high, and they decreased in the first month. After the initial testing, the virus was detected three times, but it became undetectable by one month of age. The child and mother were unreachable for more testing for one year, and during that time the child did not receive treatment. The child returned for testing at 23 months old, and viral loads were miraculously still undetectable. Today, at 3 years old, the child is still HIV free.
"This could prevent a lifetime of treatment," says Dr. Rowena Johnston, director of The Foundation for AIDS Research. "We want people to understand just how game changing this may be."
In the most recent case, a baby girl born in California was treated immediately after birth, just like the first baby in Mississippi. And also like the Mississippi case, the California baby's mother did not take her HIV medicine to protect her newborn from the disease, prompting doctors to take immediate action. Nine months later, the California baby is still on three medications, but remains HIV free.
Virologist Dr. Deborah Persaud, who has run ultrasensitive tests on both U.S. children in her lab at the Johns Hopkins Children's Center in Baltimore, believes that it is incorrect to label the baby as "cured" or "in remission" since she is still on the drugs for treatment. But, because the most sensitive blood tests can find no virus capable of replicating, she describes the baby as "having sero-reverted to HIV negative."
"We don't know if the baby is in remission, but it looks like that," says Dr. Yvonne Bryson, Mattell Children's Hospital UCLA specialist who is working with the California infant.
Canadian doctors are now working with similar treatments and at least five more babies are in the same position as the California and Mississippi babies, showing no signs of any infection.
"Some of the early treated children exhibited sustained virologic suppression, meaning that their HIV viral load continues to be undetectable," says Hugo Soudeyns, microbiologist from Ste-Justine Hospital in Montreal.
Preliminary data for the Canadian babies will be presented at a scientific conference in May.
According to UNAIDS, more than 260,000 children were infected globally with HIV either at birth or through breastfeeding in 2012.
"Really, the only way we can prove that we have accomplished remission in these kids is by taking them off treatment and that's not without risk," Persaud says. "This is a call to action for us to mobilize and be able to learn from these cases."