March 6, 2013
Johns Hopkins Children's Center pediatrician Dr. Deborah Persaud reported at the 2013 Conference on Retroviruses and Opportunistic Infections that a Mississippi toddler is "functionally cured" of HIV. Duplicating the functional cure with other HIV-infected infants would offer hope to other children whose mothers transmitted the virus during pregnancy or while giving birth or breast-feeding. A "functional cure" means that, although testing reveals HIV traces in the toddler, highly sensitive tests have been unable to detect fragments of HIV virus that can replicate.
In the Mississippi case, the HIV-infected mother received no prenatal care and was diagnosed during labor. Doctors typically give an HIV-infected newborn a prophylactic combination of two drugs. In this case, Dr. Hannah Gay gave the Mississippi newborn a three-drug mixture within 30 hours of birth, without waiting for HIV test results. Gay suspects the timing of treatment was the curative factor. She explains the case in a video clip of a CNN interview, available at http://www.cnn.com/2013/03/05/health/hiv-cure-global-hope/index.html.
CDC reports that the number of HIV-infected infants born in the United States dropped by 90 percent since the 1990s, when HIV testing became a routine part of prenatal care. Doctors are able to suppress the virus enough in mothers to prevent them from transmitting it to their babies. UNAIDS Global Report estimates that 1,000 HIV-infected infants are born each day; there are 330,000 HIV-infected children, living mostly in developing countries where expectant mothers are less likely to be tested and treated for HIV. For example, only three percent of HIV-infected pregnant women in North Africa and the Middle East and 23 percent of women in West and Central Africa received antiretroviral therapy.
Current World Health Organization (WHO) pediatric treatment guidance will remain in place pending results of future studies and clinical trials, according to Dr. Meg Doherty, coordinator of treatment and care for WHO's Department of HIV/AIDS.