{"id":1318,"date":"2014-10-16T16:26:26","date_gmt":"2014-10-16T16:26:26","guid":{"rendered":"http:\/\/www.lifeandnews.com\/articles\/?p=1318"},"modified":"2016-08-20T19:34:21","modified_gmt":"2016-08-20T19:34:21","slug":"end-to-hiv-no-closer-as-early-treatment-fails-to-cure-baby","status":"publish","type":"post","link":"https:\/\/www.lifeandnews.com\/articles\/end-to-hiv-no-closer-as-early-treatment-fails-to-cure-baby\/","title":{"rendered":"End to HIV no closer as early treatment fails to cure baby"},"content":{"rendered":"

By Reema Rattan<\/a>, The Conversation<\/em><\/p>\n

A second case of a baby who was ostensibly \u201ccured\u201d of HIV after early treatment has been discounted as a possible breakthrough in fighting the disease.<\/p>\n

The case of an Italian baby<\/a> who relapsed after appearing to clear the HIV virus is not comparable to the \u201cMississippi baby<\/a>\u201d who showed no sign of the virus for 27 months after treatment stopped, experts say.<\/p>\n

\u201cIt is of absolutely no surprise that the [Italian] child rebounded because that is what happens in 99% of people who stop treatment,\u201d said Professor Sharon Lewin, director of the Doherty Institute for Infection and Immunity at The University of Melbourne.<\/p>\n

\u201cWhen the case of the Mississippi baby was recorded, she had been off treatment already for 18 months and had no rebound \u2013 and that was totally unique,\u201d she added. \u201cOf course, she went on to rebound after 27 months, but the fact that she went that long was what made her unique.\u201d<\/p>\n

Head of the HIV Service at the Sydney Children\u2019s Hospital, Professor John Ziegler said the two babies’ circumstances were completely different.<\/p>\n

\u201cThe two babies had quite different exposure histories,\u201d Professor Ziegler said.<\/p>\n

According to a case report published today in The Lancet<\/a>, the so-called Milan baby was born to a HIV-positive mother whose status wasn\u2019t known until she went into labour. Tests conducted within 12 hours of his birth showed a massive load of HIV in his blood and doctors started him on prophylaxis treatment.<\/p>\n

\u201cProphylaxis is the standard approach for treating high-risk infants, who are born to HIV-positive mothers who haven\u2019t received treatment,\u201d Professor Lewin said. \u201cThe idea here is that you stop that infant from getting infected.\u201d<\/p>\n

While the HIV status of the Mississippi baby\u2019s mother was also not known until she was in labour, the child was given the full suite of antiretroviral treatment 30 hours after her birth.<\/p>\n

Doctors started the Milan baby on equivalent treatment when he was four days old, and the virus was no longer detectable in his blood after six months. Antiretroviral therapy was stopped when he was three years old and his viral load rebounded.<\/p>\n

Doctors lost contact with the Mississippi baby and her mother when she was 18 months old. When they next met the child, she had been off antiretrovirals for five months and did not show signs of the virus. It wasn\u2019t until the child was four years old that HIV was again detected in her blood.<\/p>\n

The exact reasons for the different outcomes are not known, but there are several possibilities.<\/p>\n

\u201cThe Mississippi baby didn\u2019t get prophylaxis and then full treatment, she got full treatment from the word go,\u201d Professor Lewin said. \u201cWe don\u2019t know whether that made a difference or not but that was one key difference.\u201d<\/p>\n

According to the authors of today\u2019s case report, another reason for the Milan baby\u2019s early viral rebound could be the timing of the infection.<\/p>\n

Professor Ziegler said the Milan baby\u2019s high viral load at birth suggested he had been infected for many days, or weeks already.<\/p>\n

\u201cThat means he was exposed to the virus when his immune system was very immature, so you\u2019d expect a very high burden of infection,\u201d he said.<\/p>\n

Professor Lewin said HIV, like some other viruses including the herpes virus, found places to hide in the body so it persisted even when blood tests fail to find traces.<\/p>\n

We think long-lived immune cells, known as T cells, are probably the most important HIV reservoir, she said. They are known as memory cells because they \u201cremember\u201d pathogens they have encountered before, which is how we are protected from an infection after receiving a vaccine. Most babies’ T cells are not yet memory cells because they have not been educated to become memory cells.<\/p>\n

\u201cIt is possible that treating a baby very early means that you can reduce the amount of virus that goes into hiding, because there just aren\u2019t any memory cells around to infect,\u201d she said.<\/p>\n

\"The<\/p>\n

This article was originally published on The Conversation<\/a>.
\nRead the original article<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

By Reema Rattan, The Conversation A second case of a baby who was ostensibly \u201ccured\u201d of HIV after early treatment has been discounted as a possible breakthrough in fighting the disease. The case of an Italian baby who relapsed after appearing to clear the HIV virus is not comparable to the \u201cMississippi baby\u201d who showed […]<\/p>\n","protected":false},"author":39,"featured_media":6837,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[42],"tags":[],"_links":{"self":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/1318"}],"collection":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/users\/39"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/comments?post=1318"}],"version-history":[{"count":2,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/1318\/revisions"}],"predecessor-version":[{"id":6838,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/1318\/revisions\/6838"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media\/6837"}],"wp:attachment":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media?parent=1318"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/categories?post=1318"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/tags?post=1318"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}