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Toddler cured of HIV

A Mississippi-born girl, now two and half years old, has been functionally cured of the human immunodeficiency virus (HIV) after being treated with three antiretroviral drugs, according to a case that was presented during the annual Conference on Retroviruses and Opportunistic Infections in Atlanta.

The child is now the second person ever documented to be cured of the virus. The first, a man named Timothy Brown, was cured as an adult as a result of a bone-marrow transplant he received to treat his leukemia.

The researchers called it a functional cure which means that the presence of the virus is so small, that standard clinical tests cannot detect the virus in the blood.

The child was born prematurely in July 2010, was delivered at 35 weeks to anHIV-infected mother who had not received antiretroviral medication or prenatal care.

Because of the high risk for exposure to HIV, the infant was treated more aggressively, and was started on liquid antiretroviral treatment at 30 hours of age, which consisted of a combination of 3 anti-HIV drugs (ART), instead of the more traditional treatment of a single antiretroviral drug to try to prevent transmission after birth.

“I just felt like this baby was at higher-than-normal risk, and deserved our best shot,” said Dr. Hannah Gay, a pediatric HIV specialist at the University of Mississippi Medical Center, who had the child in care.

The baby continued to receive treatment and by the time she was month old, the virus no longer could be detected in the blood, and doctors continued the treatment until she was 18 months old, until the mother disappeared and the toddler did not receive any further medication and did not see doctors again until she was nearly 23 months old.

When she was eventually brought back to the hospital, doctors say they were shocked after re-testing the baby, expecting that she would have a high viral load, instead, "All of the tests came back negative, very much to my surprise" and "Now, after at least one year of taking no medicine, this child's blood remains free of virus even on the most sensitive tests available," said Dr. Gay.

Dr. Deborah Persaud, a virologist with Johns Hopkins Children's Center, was lead author on the report presented at the conference said that the early treatment likely led to the infant's cure.

"This case suggests that providing antiretroviral therapy within the very first few days of life to infants infected with HIV through their mothers via pregnancy or delivery may prevent HIV from establishing a reservoir, or hiding place, in their bodies and, therefore, achieve a cure for those children."

But until the scientists understand how they cured the child, doctors have warned that anyone who takes the drugs must remain on them.

"It is far too early for anyone to try stopping effective therapy just to see if the virus comes back," added Gay. "Prevention really is the best cure, and we already have proven strategies that can prevent 98% of newborn infections by identifying and treating HIV-positive women."

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