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Medicine

Researchers Describe First 'Functional HIV Cure' In an Infant 71

Posted by samzenpus
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."
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Researchers Describe First 'Functional HIV Cure' In an Infant

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  • by Anonymous Coward on Monday March 04, 2013 @09:10AM (#43066561)

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

  • by Anonymous Coward

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

    • by History's Coming To (1059484) on Monday March 04, 2013 @09:25AM (#43066647) Journal
      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.
      • by Chrisq (894406)

        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.

      • by Shavano (2541114)
        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.
      • 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.

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

      • by Anonymous Coward

        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 ne

      • by sjames (1099)

        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.

    • by GauteL (29207)

      "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?

    • by sjames (1099)

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

  • 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.
    • by Anonymous Coward

      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.

  • 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.
  • Science.... (Score:2, Informative)

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

    • by timeOday (582209)
      Not sure in what sense you meant that, but it would be premature to start running around having unprotected sex with everybody in celebration.
  • by GauteL (29207) on Monday March 04, 2013 @09:37AM (#43066721)

    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.

    • by Sarten-X (1102295)

      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.

    • by moeinvt (851793)

      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 a

      • by u38cg (607297)
        And you know that they knew their status at the time how?
      • 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 may never see a cure for any of the illnesses out there. Big Pharma makes more money on treating than curing.
  • Yeah, right (Score:4, Insightful)

    by mvar (1386987) on Monday March 04, 2013 @09:54AM (#43066801)

    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

    • Re:Yeah, right (Score:4, Insightful)

      by Sarten-X (1102295) on Monday March 04, 2013 @10:45AM (#43067459) Homepage

      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.

  • 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 was

  • They shouldn't have published these results.

    This will just lead to irresponsible behavior in infants.

In any formula, constants (especially those obtained from handbooks) are to be treated as variables.

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