A toddler in Italy was believed to be cured of HIV following an aggressive treatment administered just following his birth, but doctors have reported that the boy has suffered a relapse. A case report to be published in The Lancet on October 4 said that two weeks after ceasing antiretroviral medications, the toddler rebounded.
The baby’s HIV levels remained undetectable after the child was 6-months-old, HealthDay News reported. A 4-year-old Mississippi child also relapsed after doctors thought she was cured. In her situation, she was able to live two years without her antiretroviral medications, and her blood tests showed her as free of HIV until her relapse.
“What we’ve learned here is if you have an HIV-infected child who started treatment early, the fact that you have negative tests does not signify that the child has been cured or that they can be taken off treatment,” Dr. Deborah Persaud, HIV expert and professor of infectious diseases at the John Hopkins Children’s Center in Baltimore, explained.
The boy from Italy, referred only as the “Milan baby,” was born with a heavy HIV viral load to an HIV-positive mother in December 2009. He was quickly given the drugs to treat his HIV, and right away his levels dropped. By six months, the HIV was considered undetectable. When he turned 3-years-old, his blood test suggested that he had been cured of HIV, and his HIV antibodies that had developed were also gone.
“Unfortunately, the virus had been hiding in reservoirs deep in the child’s immune system, and immediately rebounded, the researchers said. The cases highlight the difficulty of eliminating HIV from deep within the immune system,” HealthDay News reported.
Doctors still believe that HIV therapy can provide a functional cure to children born HIV positive, even in the face of setbacks like these two cases, but ideally, it is believed that HIV therapy should be given prior to birth to HIV-positive mothers in order to reduce the chance of transmission to the infant completely.
“I think we will find a functional cure. We just haven’t found it yet,” Dr. Horberg, director of HIV/AIDS for Kaiser Permanente, said. “That doesn’t mean the principles of a strategy of hitting hard for an extended period should not work.”
Timothy Brown, known as “the Berlin patient” has been clear of HIV since 2008. According to The Guardian, he received a bone marrow transplant from a donor who displayed a natural immunity to HIV. That treatment was studied and clinical trials have begun as researchers hope to discover if immune cells that have been modified to carry natural resistance to HIV could be infused into a patient instead.
Infectious disease specialist at North Shore University Hospital Dr. Bruce Hirsch reportedly said that doctors shouldn’t get set on finding a cure because current drug therapies are very successful at controlling HIV infection.
“Our treatments are very well-tolerated, and I think we should avoid cures that are worse than the treated disease itself,” Hirsch said of potentially risky therapies being researched to offer cures for HIV.