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Researchers Describe First 'Functional HIV Cure' In an Infant

Posted by samzenpus on from the one-step-closer dept.

An anonymous reader writes in with news of a breakthrough in the treatment of HIV. "A baby born with the AIDS virus two years ago in Mississippi who was put on antiretroviral therapy within hours of birth appears to have been cured of the infection, researchers said Sunday at a scientific conference in Atlanta. Whether the cure is complete and permanent, or only partial and long-lasting, is not certain. Either way, the highly unusual case raises hope for the more than 300,000 babies born with the infection around the world each year."

38 of 71 comments (clear)

  1. Doesn't matter to me by Anonymous Coward · · Score: 3, Funny

    It comes too late....no unsafe sex orgies for me :(

    1. Re:Doesn't matter to me by Opportunist · · Score: 1

      From a purely evolutionary point of view, he has his priorities straight.

      --
      We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
  2. Was the baby infected? by Anonymous Coward · · Score: 1

    The article makes it sound like the baby might never have been infected to begin with.

    1. Re:Was the baby infected? by History's+Coming+To · · Score: 5, Informative

      The baby was infected, but this is a "functional cure", it works like this: Whilst in-utero the baby receives a certain amount of protection from the mother's immune system and the filtering of the placenta. When it's born it does have the virus, and then the baby's own immune system begins to kick in. At this point, immediately after birth, they begin an aggressive but fairly standard treatment with antiviral medication. This suppresses the virus enough that the immune system then has a fighting chance, and whilst the virus is unlikely to be completely eradicated it is in theory manageable by the immune system for the rest of the baby's life. The virus is still there, but kept to very low levels so developing AIDS or passing the virus on becomes very unlikely.

      This approach may work with adults, but you have to get in there very quickly with the antivirals, so it's more likely to work with, for example, a nurse who gets a needlestick injury than a person who contracted it days before. The developing immune system in infants may also play a part, so this may never be a "functional cure" in adults, but it's certainly a step forward.

      Remember, we don't necessarily need to cure things like HIV and cancer, we just need to keep them at bay until something else kills the patient, that still counts as a functional cure.

      --
      Please consider this account deleted, I just can't be bothered with the spam anymore.
    2. Re:Was the baby infected? by GauteL · · Score: 2

      "Once there, paediatric HIV specialist Dr Hannah Gay put the infant on a cocktail of three standard HIV-fighting drugs at just 30 hours old, even before laboratory tests came back confirming the infection."

      The last part of this sentence states that infection was confirmed. However, I'd be interested to know the rate of false positives versus the rate of false negatives. There is surely always a chance that the positive tests were wrong?

    3. Re:Was the baby infected? by Chrisq · · Score: 2

      The baby was infected, but this is a "functional cure", it works like this: Whilst in-utero the baby receives a certain amount of protection from the mother's immune system and the filtering of the placenta. When it's born it does have the virus, and then the baby's own immune system begins to kick in. At this point, immediately after birth, they begin an aggressive but fairly standard treatment with antiviral medication. This suppresses the virus enough that the immune system then has a fighting chance, and whilst the virus is unlikely to be completely eradicated it is in theory manageable by the immune system for the rest of the baby's life. The virus is still there, but kept to very low levels so developing AIDS or passing the virus on becomes very unlikely.

      I was thinking that maybe it worked because the treatment was before the baby's immune system kicked in. As HIV spreads by infecting the immune system clearing the load before then could clear the infection.

    4. Re:Was the baby infected? by __aaltlg1547 · · Score: 2

      A baby born to an infected mother will have antibodies but not necessarily virus. It takes a very sevsitive test to verify the presence of virus, and such a test gets false positives. It's hard to really rule out the possibility the baby was born uninfected.

    5. Re:Was the baby infected? by Alwin+Henseler · · Score: 1

      Remember, we don't necessarily need to cure things like HIV and cancer, we just need to keep them at bay until something else kills the patient, that still counts as a functional cure.

      If that involves -likely expensive- medication: go tell that to the many HIV-infected people in 3rd world nations. Something tells me they won't be impressed. Apart from having to take that medication regularly. Better than dying from AIDS, but a 'cure' in any sense of the word? Nope.

      This case could be a great step forward in the fight against HIV, if researchers can unravel the mechanisms involved. But that is big if, and a sample size of 1 may not say much either.

    6. Re:Was the baby infected? by Anonymous Coward · · Score: 1

      Actually, it does work in adults, and it can eliminate the virus.

      Amongst other things, something with exponential growth is hard to control in a steady-state situation. A slight imbalance and it tends to either rapidly decline, or grow. Especially when it is something that mutates as readily has the HIV virus.

      Also, a good friend of mine has a mother who worked in the trauma center of a hospital. Many years ago, a heroin addict came in after a rather nasty fight. While they were treating him, he grabbed a needle that had been used on him and started stabbing at people. Her mom, and several others were stabbed. Within an hour, they pumped all of the people who were stabbed full of an antiviral cocktail (I can't remember if there were repeated treatments). They also tested to man to verify he had HIV, though they had to use the AV cocktail before they got results, to be safe. Only one ended up contracting HIV (not my friends mom). For the other four or five - no more continued treatment or need to be careful of infecting others. From what I understand, the AV cocktail has about an 80% success if administered in 24 hours, and the initial "dose" is low.

    7. Re:Was the baby infected? by History's+Coming+To · · Score: 1

      The sad thing is that a lot of the cost is down to pharma companies (quite fairly) needing to recoup the substantial R&D involved. I'd like to see the world's governments get together, work out how much the companies are due, buying the licence from them and then distributing free or low cost treatments.

      --
      Please consider this account deleted, I just can't be bothered with the spam anymore.
    8. Re:Was the baby infected? by del_diablo · · Score: 1

      In daily speech you say "Do I have X?", while in reality, you ask "Do I have X on a unusual large amount?"

    9. Re:Was the baby infected? by sjames · · Score: 1

      That is a possibility they cannot exclude to certainty, but it looks like the baby was more likely than not infected.

    10. Re:Was the baby infected? by sjames · · Score: 1

      Actually, they're calling this a functional cure for now since they can't yet prove it is an actual cure. However, since the baby went for some time untreated after starting the treatment and still showed no viral load, they have reason to believe that it is an actual cure.

      The gold standard test for this (stop all treatment and see if it stays gone) is completely unethical, so they have to find a safe way to make the determination for sure.

  3. Round one to doctors! by Murdoch5 · · Score: 1

    That's awesome news. HIV is almost the ultimate disease, getting the immune system to turn against itself, so it's really awesome that at least cures are starting to look in the right direction, even if it's not lifelong it's at least a step in the right direction.

    1. Re:Round one to doctors! by Anonymous Coward · · Score: 1

      It is not a cure. I wish it was, but it isn't. Scientists have simply found an infant where they were able to annihilate the HIV. I don't see a lot of applications, since they used the standard treatment and got lucky. The best that can be said is that early antiretroviral treatment has the possibility of defeating HIV, especially in infants (which have a 25% transfer rate from their mothers). For those who have already tested positive for HIV, this isn't going to be much comfort.

  4. A Wonderful Thing! by tomknight · · Score: 1

    This is fantastic news, and offers the beginning of a glimmer of hope across the world. Transferring these benefits to sub-Saharan Africa (for example) will require incredible changes to drug marketing/profit-making, but also cultural changes. Ultimately this would have massive positive economic benefits in this region, but the political will and strength required to make this available is immense.

    --
    Oh arse
  5. Science.... by bleh-of-the-huns · · Score: 1, Informative

    Fuck yeah (shamelessly stolen from an image passed on to me earlier today)

    --
    I came, I conquered, I coredumped
    1. Re:Science.... by timeOday · · Score: 2

      Not sure in what sense you meant that, but it would be premature to start running around having unprotected sex with everybody in celebration.

  6. Have the parents been relieved of their duties? by GauteL · · Score: 4, Interesting

    While having an HIV-infected mother may give an impression of irresponsibility, there are people out there with no history of promiscuity or drug use that have caught HIV for many different reasons. I won't make judgements based on this.

    But the following two newspaper quotes caught my attention.

    BBC:

    The treatment was continued for 18 months, at which point the child disappeared from the medical system. Five months later the mother and child turned up again but had stopped the treatment in this interim.

    Washington Post:

    "The child’s mother began missing appointments after a year. At 18 months, the child was no longer on treatment. When the child was brought back to the clinic at 23 months, the viral load was still undetectable, “very much to my surprise,” Gay wrote.

    It strikes me as wildly irresponsible to the point of criminal neglect to miss medical appointments for your HIV-infected child. It does not appear as if she was told it was ok not to turn up for these appointments. After all, the doctors expected the HIV infection to return if the drug treatment wasn't kept up. If this had happened, and the child had died, I would have expected the mother to be prosecuted for manslaughter.

    1. Re:Have the parents been relieved of their duties? by GauteL · · Score: 1

      I would argue that it isn't HER child if you emphasised her in order to establish ownership.

      I am approaching this from a European perspective, which tends to be that the child does not belong to the parents. Instead the child belongs to itself, and the parents are merely the guardians. From this perspective, the parents autonomy over their children is limited, and life-threatening irrationality should lead to you being relieved of your duties as guardian.

      The most obvious example is the case from England of the mother who refused cancer treatment for her child, and ran away with him. Not only was did the English courts decide the treatment had to go ahead despite the mother's wishes, but her documented willingness to run away with the child, meant the child was ordered into foster care.

    2. Re:Have the parents been relieved of their duties? by Sarten-X · · Score: 1

      Having worked in the medical world, this is unsurprising. From what I saw, patients often leave treatment against the wishes of their doctors. Some lose faith in the treatment's outcome, some get their first few rounds of bills and realize they can't afford care, and some have other committments that get in the way. What's particularly interesting in this case is that the patient(s) came back. That's promising.

      --
      You do not have a moral or legal right to do absolutely anything you want.
    3. Re:Have the parents been relieved of their duties? by moeinvt · · Score: 1

      The method by which they contracted AIDS is irrelevant. If a person knows they are HIV+ and still makes the decision to procreate, I question their morality.

      HIV+ people have been charged with a crime for spitting on others. i.e. attempting to infect a healthy person with the HIV virus. Why does the same crime suddenly become acceptable when the virus is transferred in the womb? The so-called "parent" could start experiencing full blown AIDS symptoms at any moment and leave the child an orphan. Hardly an optimal outcome. If the child gets the virus (not certain, but a huge risk) they'll have the same dark cloud hanging over them and probably live an abbreviated life followed by a painful death.

      Even if we don't treat this as a crime, it should be considered socially unacceptable in the extreme.

    4. Re:Have the parents been relieved of their duties? by mjr167 · · Score: 1

      Without knowing all the details of the situation, it is impossible for us to judge them. Doctors are often wrong. When I was a child I was miss-diagnosed with cancer. one test showed cancer, but several others did not. The doctors wanted to do chemo and my parents decided to wait. Simply because a doctor recommends a treatment path does not make it the right choice.

      If a doctor performs treatment that we later deem unnecessary and kills a patient we rile against the doctor. If a parent refuses treatment for their child we rile against the parent?

    5. Re:Have the parents been relieved of their duties? by u38cg · · Score: 1

      And you know that they knew their status at the time how?

      --
      [FUCK BETA]
    6. Re:Have the parents been relieved of their duties? by Opportunist · · Score: 1

      This is something that strikes me as odd. Why is it that the same people who consider life sacred and everything has to be done to protect it until it is born are also the same people who don't give a shit about it after?

      --
      We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
    7. Re:Have the parents been relieved of their duties? by Opportunist · · Score: 1

      Yes. For exactly the same reason, making a wrong decision that harmed the child.

      --
      We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
    8. Re:Have the parents been relieved of their duties? by Opportunist · · Score: 1

      Ya know, from time to time procreation happens without a decision. Then there's that 9 months period during which a damn lot can happen.

      --
      We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
    9. Re:Have the parents been relieved of their duties? by mjr167 · · Score: 1

      Unless it was the right decision...

      Should my parents have been forced to give me chemo because a doctor thought there was a possibility I had cancer? It is very easy to look back on a decision years or even months later and know what the correct decision was. It is much harder to figure out the correct decision when the decision actually needs to be made.

      My point is that you cannot judge a parent solely based on a couple sentence summary. There are times when the treatment is worse than the disease and a point at which you need to tell a doctor enough is enough.

  7. We won't see a cure. by Westwood0720 · · Score: 1

    We may never see a cure for any of the illnesses out there. Big Pharma makes more money on treating than curing.

  8. Yeah, right by mvar · · Score: 3, Insightful

    raises hope for the more than 300,000 babies born with the infection around the world each year.

    Especially when the majority of these infants are born in "third-world" countries, where people can't afford the basic stuff like food and water, they'll be able to cure their infants with this new treatment because the big pharmas will provide it for free. Can't wait for this to happen, along with the sun rising from the west

    1. Re:Yeah, right by Sarten-X · · Score: 3, Insightful

      America's Big Pharma certainly won't routinely provide it for free, but they will happily donate a lot of doses in a tax-deductible act of charity. Through partnerships with other charitable agencies, more doses will be sent abroad. Once the medicine gets to those third-world countries, some of it will even get past the warlords and corrupt leaders to make its way to hospitals, where a few treatments might even make their way to trained doctors.

      At least one of those doctors will be paid off by a pharmaceutical company from China, Cuba, or another country that doesn't care much about American intellectual property laws, and soon cheap knock-off treatments (that work almost as well) will be produced. Those knock-off cures will be widely available in any country that isn't under the thumb of American pharmaceutical companies... which is exactly what the Big Pharma companies expect and don't mind, because they're not really pushing marketing to those countries, anyway. Sure, they'd love the extra business, but the lax distribution controls are a PR minefield they don't really care to walk through yet.

      --
      You do not have a moral or legal right to do absolutely anything you want.
  9. Re:Born in Debt by GauteL · · Score: 2

    I can't help but think of the economic outcome of procedures like this once it becomes FDA-approved, mainstream treatment.

    Anti-HIV drugs are outrageously expensive, partly because it's a long-term treatment. Incurring this expense at birth would severely affect one's ability to earn a decent living later on, even before being hit my student loans, mortgage, etc.

    A new generation of complete povery is imminent.

    Did you read the article or the summary? Did you even read the head line? The whole point of the story is the possibility that if treatment is given early enough it can become a functional cure, whereupon you may not need to receive any more treatment, ever, because your immune system can deal with it for the rest of your life.

    The whole point of this story is the (possibly) good news that we may avoid exactly what you describe.

  10. Humor. Try it some time. by Anonymous Coward · · Score: 1

    http://youtu.be/JdrcOGoszlE

  11. Re:So now we only need a time machine! by LeadSongDog · · Score: 2

    That wretched continent breeds nothing but human incompetence and disease.

    Homo sapiens isn't the only species to come out of Africa,

    --
    Oh, I'm sorry sir, I thought you were referring to me, Mr. Wensleydale.
  12. Re:Born in Debt by Opportunist · · Score: 1

    And people ask me why I love our "socialist" healthcare system where you pay a fixed premium and get whatever treatment you need...

    --
    We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
  13. Re:HIV is NOT the cause of 'AIDS' by Opportunist · · Score: 1

    I don't know exactly what AIDS is, right. But then again, I am also kinda wary to take medical advice from a mathematician...

    --
    We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
  14. Crap Science by hackus · · Score: 1

    Which is something I would throw this into a pile of all the other crap science I read about on a day to day basis...(i.e. Climate Change Carbon Credit Exchanges will save the world!!!)

    So let me get this straight, they "SAY" the infant is cured, but can't say:

    1) Why
    2) How Long
    3) or even if it is complete or partial

    If you cannot make the most BASIC presumptions about the HIV status of an infant, after spending billions and decades of dollars on the problem the science is nothing but a institutional brain washing of the public.

    I am sorry, but there is almost no difference between the guy I just posted about who "tinkered" with 3D printing and considered an amateur because he didn't want to do Mathematics and therefore is named a "undergraduate". Yet somehow, researchers are not undergraduates and post crap like this after decades of research, billions of dollars and seemingly can't even track the disease in the organism it spent billions on researching?

    Crap science.

    Sort of like listening to climate idiots talking about humans and animals on the planet have to die because CO2 is a poison and it is killing the planet, with PhD's and research that is suppose to be scientific, yet the same research can't even tell me what the wether is going to be like a week from now.

    Yet, somehow we are suppose to kill ourselves because in 70 some years the earth will be dead.

    BULLSH*T, CRAP SCIENCE.

    -Hack

    --
    Got Geometrodynamics? Awe, too hard to figure out? Too bad.
  15. Irresponsible by formfeed · · Score: 1

    They shouldn't have published these results.

    This will just lead to irresponsible behavior in infants.