Monday, March 04, 2013

CROI Abstract: 'Functional HIV Cure' of Positive Infant

My good friend and science reporter Bob Roehr sent me email before heading to Atlanta for the Conference on Retroviruses and Opportunistic Infection, and before the big news this weekend about the HIV positive baby in Mississippi being essentially cured of the virus. Can't recall the last time I paid attention to CROI and the abstracts presented, so thanks, Bob, for the reminder.

Like many others, I'm excited by the news of the infant's cure and want more information about it, which is why I read the abstract at the CROI site. I'm sure we'll be reading much more about this infant the apparent eradication of HIV from his or her body. Here's an excerpt:

Background: A single case of HIV cure occurred in an infected adult with a bone marrow transplant. We report a case of functional HIV cure in a 26-month-old infected child who initiated ART at 30 hours of age.

Methods: Infant exposure to HIV was confirmed through review of maternal HIV antibody and plasma viral load tests, including HIV drug resistance testing. Infant infection was documented using standard HIV DNA polymerase chain reaction (PCR) and plasma viral load. ART administration was confirmed with medical and pharmacy records and maternal report of medication adherence . . .

Results: Maternal infection with wild type subtype B HIV was verified. The mother and infant shared HLA haplotypes. Infant infection was confirmed by positive HIV DNA and RNA testing on 2 separate blood samples obtained on the 2nd day of life. 3 additional plasma viral load tests (days of life 7, 12, and 20) were positive before reaching undetectable levels at age 29 days.Plasma HIV RNA remained undetectable . . . At age 26 months HIV DNA was detected at 4 copies/million PBMC but with no 2-LTR circles. Plasma viral load, PBMC DNA, and HIV-specific antibodies remained undetectable with standard clinical assays, confirming a state of functional HIV cure.

Conclusions: This is the first well-documented case of functional cure in an HIV+ child and suggests that very early ART may prevent establishment of a latent reservoir and achieve cure in children.

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