Among the stories making headlines from the 2014 Conference on Retroviruses and Opportunistic Infections (CROI) in Boston this week was the next chapter in the story of the Mississippi baby whose case Dr. Deborah Persaud shared at last year’s conference.
This year, she and her colleagues shared an update on the status of that child and discussed the case of a second infant from the Los Angeles area who was also perinatally infected with HIV and similarly started on combination antiretroviral treatment very soon after birth. Now over three years old, the Mississippi child has been off HIV treatment for 21 months and has remained in remission. Using the same very sensitive tests, the researchers can find no HIV virus capable of replicating in the Los Angeles infant’s blood, either. That child, now 9 months old, remains on HIV treatment.
As Dr. Persaud shared with us, “We know that this does not represent that we have cured HIV or cleared HIV, but what it tells us is that with early treatment, we can really prevent the rapid spread of HIV to cells within an infected child.” She and other researchers are considering whether these findings signal that giving very early HIV treatment restricts HIV’s spread to point where it becomes difficult to detect infection and prevents the establishment of viral reservoirs. “So, we’re still at the beginning of trying to figure out how to reach a functional cure in HIV-infected persons…These cases give us information in terms of how we can prevent HIV from establishing its foothold in the bloodstream of infected individuals. But we still really don’t have a way to achieve cure in any HIV-infected person at this point.”
View my conversation with Dr. Persaud below.
To learn more, read the abstract in the conference materials available online (search for abstract number 75LB Very Early Combination Antiretroviral Therapy in Perinatal HIV Infection: Two Case Studies) or view the session at which Dr. Persaud presented the findings.
At the conference, Dr. Persaud noted that a clinical trial to further investigate whether very early intensive treatment of HIV-infected infants can lead to HIV remission will soon commence under the auspices of the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) Network. IMPAACT is primarily funded by the National Institutes of Health.