
HIV-Infected Infant Cured With Early Use of AIDS Drugs - themichael
http://www.bloomberg.com/news/2013-03-03/hiv-infected-infant-cured-with-early-use-of-virus-blocking-drugs.html
======
carbocation
One has to wonder if the infant is homozygous for the noted CCR5 variant that
confers resistance to HIV infection. This could potentially explain a high
viral load with negative titers later.

I can't tell (from the relatively scant details) if the child ever developed
HIV infection, by which I specifically mean to include infiltration of a cell
by the virus, replication, and a host reaction. I can't find text in the
articles describing which blood tests were done on the child. If her ELISA and
Western blot are negative (still) but she initially had a nucleic acid
amplification test that was positive with high titer, then it would make me
wonder if the drugs, for this baby, were not necessarily the key element
causing her to be disease free. I.e., I would wonder if the infant weren't
actually cured because she was never fully infected in the first place.

If she was truly infected and her body was reacting to the replicated
pathogen, then this early treatment strategy is extremely interesting.

~~~
HarryHirsch
Also see: the Milwaukee protocol for rabies. No one knows just why it works
for some people but not for others, but early treatment is key.

------
emiliobumachar
For those of you too young to remember the 90's, AIDS meant sure death in very
few years. It was worse than cancer: with some cancers, you stood a chance.

How far we've come :)

~~~
ekianjo
My understanding is HIV is still more or less a death sentence, with the
antiretroviral therapies being relatively effective to push back the final
outcome. And there are issues not being discussed here, such as compliance
issues with the treatments (adverse reactions and so on) that make patients
drop the treatments. It's far from being perfect yet.

~~~
carbocation
It's more of a chronic disease than a death sentence. We all die, and if you
push back the final outcome far enough, your odds of dying from something else
outgun your odds of dying from HIV/AIDS.

For example, those with HAART-treated HIV infection who have been treated for
four years or more tend to die from a non-AIDS-related cause rather than from
an AIDS-related one. [1]

[1] = <https://www.ncbi.nlm.nih.gov/pubmed/20380565>

------
gojomo
I wonder how this child's "blood remains free of the virus" status compares to
the 'undetectable' viral loads reported for others (eg Magic Johnson) for many
years. Is there a qualitative difference?

~~~
kintamanimatt
Such people who are undetectable are also on meds. People who are not on meds
don't have undetectable viral loads.

I wonder if the kid has the CCR5-Δ32 mutation, which seems to provide natural
immunity against certain strains of HIV.

------
tokenadult
The treatment details from this interesting article and from the Guardian
article

[http://www.guardian.co.uk/society/2013/mar/03/us-doctors-
cur...](http://www.guardian.co.uk/society/2013/mar/03/us-doctors-cure-child-
born-hiv)

and New York Times article

[http://www.nytimes.com/2013/03/04/health/for-first-time-
baby...](http://www.nytimes.com/2013/03/04/health/for-first-time-baby-cured-
of-hiv-doctors-say.html)

just submitted to HN

<http://news.ycombinator.com/item?id=5315660>

<http://news.ycombinator.com/item?id=5315673>

make clear that this is a very unusual case. The baby's HIV infection was
acquired from an infected mother, but her HIV status was not known until she
was in labor. Because she did not receive the usual preventive treatment given
to HIV-positive pregnant women, the baby received three-drug therapy rather
than one-drug therapy as the baby's treatment began after birth. The baby's
current status of no detectable infection after a hiatus in drug therapy is a
very unusual outcome. It's unclear how likely it is that this result could be
reproduced in other patients. Thousands of failures to attain the same outcome
have already happened all around the world.

From the Bloomberg article submitted to open this thread:

"The baby, whose identity has been kept anonymous, began taking a regimen of
AIDS drugs about 30 hours after she was born at a rural Mississippi hospital,
doctors said today at a medical meeting in Atlanta. At 18 months, the mother
took the child off the medication. With no signs of the virus for 10 months,
the infant was deemed 'functionally cured,' researchers said.

. . . .

"The baby’s treatment combined lamivudine and zidovudine, both sold by
GlaxoSmithKline Plc’s joint venture with Pfizer Inc., ViiV Healthcare, and
Abbott Laboratories’ Kaletra."

From the New York Times article:

"If the report is confirmed, the child born in Mississippi would be only the
second well-documented case of a cure in the world, giving a boost to research
aimed at a cure, something that only a few years ago was thought to be
virtually impossible.

"The first person cured was Timothy Brown, known as the 'Berlin patient,' a
middle-aged man with leukemia who received a bone-marrow transplant from a
donor genetically resistant to H.I.V. infection."

From the Guardian article:

"Children infected with HIV are given antiretroviral drugs with the intent to
treat them for life, and Gay warned that anyone who takes the drugs must
remain on them.

"'It is far too early for anyone to try stopping effective therapy just to see
if the virus comes back,, she said."

AFTER EDIT: Following up on some of the other top-level comments here, gojomo
asks how the case reported in this thread differs from Magic Johnson's
condition. Magic Johnson has consistently taken his antiretroviral drugs,
which were first developed only shortly before his HIV infection was
diagnosed, throughout the decades since he was diagnosed. He has never had a
hiatus in treatment. What's remarkable about the case reported today is that
the baby's treatment was stopped at about age eighteen months, but the child
still has no detectable HIV infection.

I remember all too well when AIDS was a sure death sentence. The development
of effective antiretroviral drugs in the early 1990s was a huge surprise. Even
today, there are very few drugs that are effective against any kind of viral
infection (although there are many vaccines that kind prevent viral
infections, and smallpox has been completely eliminated from humankind).

Another comment asked about cures for diseases announced in recent years. For
the most part, reductions in disease risk are gradual, mostly from
accumulation of better practice in treatment and prevention. But the death
rate from all causes of death at all ages is steadily declining in the
developed world,

[http://www.scientificamerican.com/article.cfm?id=longevity-w...](http://www.scientificamerican.com/article.cfm?id=longevity-
why-we-die-global-life-expectancy)

and has been throughout my lifetime. For more than a century, humankind has
been gaining life expectancy at the steady rate of fourth months per year (or
one extra day of life for each day you live),

[http://www.prb.org/Journalists/Webcasts/2010/humanlongevity....](http://www.prb.org/Journalists/Webcasts/2010/humanlongevity.aspx)

[http://www.demographic-
challenge.com/files/downloads/2eb51e2...](http://www.demographic-
challenge.com/files/downloads/2eb51e2860ef54d218ce5ce19abe6a59/dc_biodemography_of_human_ageing_nature_2010_vaupel.pdf)

<http://www.pnas.org/content/105/36/13274.full>

so a girl born in the last decade in the developed world has a better than
even chance to living to age 100.

~~~
napoleond
"I remember all too well when AIDS was a sure death sentence."

There was an _excellent_ documentary released last year about the HIV/AIDS
epidemic of the 80s and 90s, which I can't recommend highly enough. It's
deeply interesting and eye-opening on several levels:
<http://surviveaplague.com/>

------
hakaaaaak
"With no signs of the virus for 10 months..."

Does this mean that the virus could still be incubating in cells and some sort
of stressor could cause the virus to come out, similar to those that have had
Chicken Pox getting Shingles later in life? If so, is it really a cure? To me,
a vaccine that has passed all trial stages and works almost 100% and w/few
side effects is a cure. I don't want to belittle this miracle, but complacency
caused by misleading news is much, much worse than playing it down and getting
it right before announcing there is a cure. Hope is a wonderful thing though.

~~~
TillE
A vaccine is not a cure. It's prevention - which already exists for mother to
child HIV transmission.

Anyway, the doctors don't make any absolutely definitive statements, but:

"Now, after at least one year of taking no medicine, this child's blood
remains free of virus even on the most sensitive tests available"

[http://www.guardian.co.uk/society/2013/mar/03/us-doctors-
cur...](http://www.guardian.co.uk/society/2013/mar/03/us-doctors-cure-child-
born-hiv)

~~~
hakaaaaak
> A vaccine is not a cure. It's prevention

True.

My point was that the title of the post indicated that the child was cured. We
don't know that yet, and may not know for some time. It will be nearly
impossible to eradicate HIV without prevention. If this child has unprotected
sex as an adult thinking that it is cured, is that safe? We don't know. Maybe
the virus will show again in their adulthood.

However, if a vaccine is found and we can prove the vaccination works, that
provides a lot more security. Because of many of our parents getting
vaccinated, Smallpox got to the point where their children (us) didn't have to
get vaccinated. That is where we need to get with HIV. Because of AZT, etc.
people just assume it is more of an annoyance now, like Herpes that can be
managed. We need adequate resources dedicated and I am concerned that touting
a cure that may not be is not in the public's best interest.

------
signed0
Being fairly young, I can not remember a time in my life when a disease was
cured or a vaccine created that significantly reduced transmission. I keep
expecting a grand announcement like "AIDS cured" or "Cancer defeated" but
there are always so many caveats that it feels like progress isn't being made.
I wonder if it was the same way with other diseases in the past, and I am just
being important, or if modern day ones are somehow different.

~~~
freiheit
Since 1980, we've developed vaccines for:

    
    
       - Hepatitis B,
       - Chicken Pox,
       - HPV,
       - Rotavirus,
       - Hepatitis A,
       - and Pneumococcal.
    

There's also been a lot of improvements in existing vaccines, regular new
Influenza strain vaccines, etc...

A lot of those simply got quietly introduced into the routine vaccination
schedule for children and the diseases quietly vanished without much fanfare
in those countries.

Polio is _almost_ eliminated world-wide now, but that's taken decades.

<http://www.cdc.gov/vaccines/pubs/vacc-timeline.htm>

[http://www.chop.edu/service/vaccine-education-
center/vaccine...](http://www.chop.edu/service/vaccine-education-
center/vaccine-schedule/history-of-vaccine-schedule.html)

~~~
signed0
That's uplifting to know! I've had several of those vaccines, but I didn't
realize that they were developed so recently.

------
OGinparadise
_Those researchers also were unable to find any trace of the virus, prompting
them to determine the baby had essentially been cured._

I am hoping for the best, it would a gift of life for millions, and drug cos
can't hold this even if it cost them billions to make. Horrible PR and all.

However, could the virus still be there but under the test's threshold?

------
anon4chan
how is this hacker news moroon

~~~
gnnr
Well you have to consider a lot of innovation with technology and medical
research led to this point. This article speaks only of the result of the
work, but surely if you dig deeper you would find there are many smart people
working on this issue, and I'd gladly lump them into the category of hackers.

------
iframe
I highly recommend this documentaries , House of numbers
<http://www.youtube.com/watch?v=fELMm5mAeXU> and The Greatest Medical Fraud in
History <http://www.youtube.com/watch?v=vT3b_0doyRk>

~~~
xutopia
Dude... where is the evidence? All I see here is posturing that HIV doesn't
cause AIDS... on the linked web site there is even someone claiming the "HIV-
virus" doesn't even exist.

~~~
iframe
Just check "how HIV tests are taken" , they don't even have virus to compare
with, they just count your AntiBodies ..

------
GeorgeJetson
The HIV-AIDS hypothesis is a hoax concocted by someone who never did any
research on HIV. Do your research please.

