The first case of long term HIV remission in a child has been revealed in the United States according to doctors.
The three year old from Mississippi was born with HIV and treated with a combination of antiviral drugs just hours after she was born.
Treatment continued until 18 months ago, but the child shows no detectable virus replicating, according to an updated report in the New England Journal of Medicine.
Early findings of the case were presented in March 2013 during a scientific meeting in Atlanta, but the newly published report adds detail and confirms what researchers say is the first documented case of HIV remission in a child.
The child’s paediatrician, Dr Hannah Gay, identified the virus and continues to monitor her progress.
She said: “We’re thrilled that the child remains off medication and has no detectable virus replicating. We’ve continued to follow the child, obviously, and she continues to do very well.
“There is no sign of the return of HIV, and we will continue to follow her for the long term.”
The child was born to an HIV-positive mother and began combination anti-retroviral treatment 30 hours after birth, until her viral load reached undetectable levels approximately a month after she was born.
The infant remained on antivirals until she was 18 months old, at which point her mother no longer brought her in for appointments and, physicians say, stopped treatment.
When she returned to care, approximately 10 months after treatment stopped, the child underwent repeated standard HIV tests, none of which detected virus in the blood, according to the report.
According to Dr Deborah Persaud,the lead author of the report and a virologist and pediatric HIV expert, the case provides exciting news for the future.
She said: “Our findings suggest that this child’s remission is not a mere fluke but the likely result of aggressive and very early therapy that may have prevented the virus from taking a hold in the child’s immune cells.
“Prompt antiviral therapy in newborns that begins within hours or days of exposure may help infants clear the virus and achieve long-term remission without the need for lifelong treatment by preventing such viral hideouts from forming in the first place.”
The researchers say the prompt administration of antiviral treatment likely led to the Mississippi child’s remission because it halted the formation of hard-to-treat viral reservoirs—dormant HIV hiding in immune cells that reignites the infection in most patients within mere weeks of stopping drug therapy.
As a result of the child’s experience, a further study will begin in 2014 to determine whether this approach could be used in all HIV-infected newborns.
Nearly 3.3 million children live with HIV worldwide, and more than 260,000 acquire the virus from their mothers during delivery despite advances in preventing mother-to-child infection.