Nearly eight months after preliminary results suggested a Mississippi toddler might have been successfully cured of HIV infection, more thorough testing and analysis have found that she is still HIV-negative. That means that in tests, she has no detectible levels of the virus, which can be transmitted from mothers to their children in the uterus, despite the fact that the toddler is no longer actively being treated. She had been given a course of antiviral medication, but has not been given the medication for well over a year.
"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," said Deborah Persaud, a pediatric HIV specialist involved in the child’s treatment, in a statement.
The three-year-old is the third person, and first child, to be pronounced cured of HIV infection without need for ongoing antiviral treatment since the virus was first identified in 1983. The other two are adults known as "the Berlin patients," one of whom is a Seattle native named Timothy Ray Brown. In 2007, 12 years after he was diagnosed as HIV-positive, Brown received a stem cell transplant in Germany from a donor with a gene mutation that confers resistance to HIV infection. Brown then received a second transplant in 2008; a year after that, Brown became the first person in whom the virus was declared completely eradicated rather than just inactive. The other Berlin patient, whose name has not been made public, was a German man given an experimental drug treatment in 1998. This patient was the only one in the experimental group who was successfully cured, with signs of inactive virus but no further symptoms.
The toddler, who was born premature at 35 weeks, was given the standard HIV treatment regimen for infants from 30 hours old. The severity of HIV infection is measured by viral load, a count of the amount of virus present in the patient; treatment can reduce viral load to low or undetectable levels but normally must be maintained to avoid a resurgence. The child’s viral load was low when measured after 29 days and remained low or undetectable as treatment continued over approximately 18 months. In this patient, however, long after treatment was stopped no sign of active virus or symptoms of ongoing infection were found.