A baby who was born with HIV in Mississippi , USA, has been cured of the disease. Now she is 2 1/2 years old, and not showing any signs of HIV. The identity of the child is not being revealed, but the case study was described at the Conference on Retroviruses and Opportunistic Infections in Atlanta in March, 2013.
Doctors gave the baby very early treatment after she was born, before a diagnosis had even been made. Her mother had tested positive for HIV during the late stages of pregnancy so they knew to take action immediately.
At the Children’s Hospital at the University of Mississippi Medical Center (UMMC) in Jackson the baby was given a cocktail of 3 drugs, all of which were already being used to treat HIV, over a day after it was born. The current practice is to treat a newborn immediately, so a wait of 30 hours is not standard. It was because of this that Dr Hannah Gay decided to administer 3 drugs all at once. The drugs given were zidovudine (also known as AZT), lamivudine, and nevirapine. Treatment then continued as standard for around 1 year.
- Zidovudine was the first HIV treatment to be approved by the US government. It is prescribed under the names Retrovir and Retrovis and is a antiretroviral drug.
- Lamivudine is made by GlaxoSmithKline and sold as Zeffix, Heptovir, Epivir, and Epivir-HBV. It is a nucleoside analog reverse transcriptase inhibitor and it used for the treatment of chronic hepatitis B as well as HIV. Long term use of lamivudine leads to emergence of a resistant hepatitis B virus, so it is very fortunate that the child has been cured of HIV.
- Nevirapine is a non-nucleoside reverse transcriptase inhibitor. It has been used since 1996 to treat HIV, but HIV quickly mutates to become resistant against the drug. Nevirapine has several severe side effects, such as liver toxicity. Nevirapine is given to pregnant women as it can reduce the risk of a mother passing on HIV by up to 50%.
Usually these drugs only manage to control the spread of HIV, however, in this case they managed to totally eradicate it. It is thought that the HIV virus usually manages to spread to areas deep within the body where medication cannot reach, and here it can re-infect the body after conventional treatment. However, in this case, the treatment was given so quickly that HIV did not have time to “dig in”.
The treatment was provided by Dr Hannah Gay, who afterwards said:
“We have, perhaps inadvertently, but in fact, cured the child”
The news only came to light because the child had missed several appointments and had stopped taken their medicine. Dr. Gay said that when she finally tested the child again, she found that it did not have HIV.
Her first reaction was panic – she thought that she had been treating a child who did not have HIV. So she then ran lab tests to analyse samples gather at the time of birth and re-confirmed that the child did indeed have HIV.
Both UMC and John Hopkins Hospital are trying to determine exactly what happened.
If they child remains free of HIV this will be the second person to ever be cured of HIV, and the first infant. The only other person who has been cured of HIV is Timothy Ray Brown, who was given a treatment for leukemia in 2007 which completely destroyed his immune system and then rebuilt it using stem cell transplants from a donor who carries a genetic mutation that resists HIV.
Doctors and health scientists are now more hopeful than ever than a cure for HIV can be found that can be used in older children, and maybe one day adults too.
Dr Hannah Gay
Dr Hannah B Gay received her education and training at the University of Mississippi School of Medicine. She specialises in Neonatal HIV, Pediatric HIV and Perinatal HIV.