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March 07, 2014

Researchers to Test Promising Therapy for HIV-infected Newborns

by Jessica Berman

U.S. officials have announced the funding of an international medical trial to see whether aggressively treating HIV-infected newborns with anti-retroviral drugs cures them.  The news follows the announcement this week that a year-old infant in California, born with the AIDS virus, shows no signs of infection after aggressive antiretroviral therapy. 

There are now two documented cases in the United States of newborns who contracted HIV in the womb going into remission following the immediate start of aggressive anti-retroviral therapy.

In both instances, the HIV-positive mothers were not in therapy at the time of delivery.

In the case of the so-called Mississippi baby, reported a year ago, doctors began giving the infant a three-drug combination of anti-AIDS drugs 30 hours after birth.  Sensitive tests showed the virus had reached undetectable levels within a month.

The baby took the drugs for a year and a half, until doctors lost track of her.  When the infant resurfaced, she had not been on therapy for 10 months but tests continued to show no sign of the virus.  Doctors say the infant, who has not taken any HIV medications now for two years, remains healthy.

In the latest case, physicians in Long Beach, California, began a cocktail of HIV drugs within four hours after birth. Almost a year later, they could detect no virus in the infant.

“Now that doesn’t mean the baby is cured or that the virus is not there, but it’s strongly suggestive of that," explained Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases and a leading researcher in the fight against AIDS. "They have not discontinued therapy in the baby.  So, they have not proven that the baby is cured as was the case with the Mississippi baby," he added.

Fauci said a large international trial will get underway in about a month to see whether HIV-infected newborns can be cured with this sort of early, aggressive treatment. “So hopefully we’ll get the answer to the question of whether this is an applicable, reproducible phenomenon,” he said.

Fauci said newborns who become infected with HIV in utero will begin antiretroviral therapy within 48 hours of birth.  They will be followed to see if the virus disappears and, in select cases, some infants may eventually be weaned from drugs.

He notes that mother to child transmission of the AIDS virus is rare in United States.  Most of the estimated 250,000 babies born infected to HIV-positive mothers every year live in developing countries, where the first time many untreated women show up to a clinic is to deliver their babies.