An American team has succeeded in making the viral load undetectable in a newborn baby infected during pregnancy by his HIV-positive mother. An interesting finding even if you have to be careful.
“If we can reproduce this case, it will be proof that we can cure HIV infection.” Dr. Deborah Persaud, American virologist and member of the University of Mississippi team, has just announced the first “functional” cure of a baby with AIDS. One year after the end of treatment, the child’s immune system can control the infection without treatment. 390,000 babies are born worldwide with HIV every year. A third die before the age of one and almost half before their second birthday.
It was during the Conference on Retroviruses and Opportunistic Infections (CROI) that the American team presented this world first.
It dates back to the fall of 2010. The mother arrives at a hospital in Mississippi and gives birth prematurely. Not having seen a doctor during the pregnancy, she does not know that she is HIV positive. Dr Hannah B. Gay, professor of pediatrics, then takes two blood tests one hour apart to test for the presence of the virus in the child. The tests will reveal a virus rate of around 20,000 copies per milliliter, which is low enough for a baby. Doctors don’t wait for results to act.
30 hours after birth, the child is treated with antiretrovirals. This is perhaps one of the keys to the success of this intervention. Because, the first surprise then reported by doctors, the levels of the virus decrease very quickly in the baby’s blood. At one month, the virus is even qualified as undetectable. The child will be followed until he is 18 months old.
But the team is forced to interrupt him, the mother no longer gives any sign of life. When she returns to the medical center five months later, Dr Gay expects to see a high viral load in the baby. However, all the new tests carried out on the child turn out to be negative. Suspecting a lab error, she ordered more tests. “To my surprise, all of these tests were still negative,” says Dr Hannah B. Gay.
The treatment therefore enabled the virus to be neutralized, possibly preventing it from forming reservoirs which are often the cause of the return of the disease. In addition, the child seems to have developed a personal immunity which is able to kill viruses when they appear.
Although it is still unknown at this time whether the virus has been completely eradicated, its presence today remains so low that the child’s body’s immune system can control it without antiretroviral treatment, the scientists explained. doctors gathered at the CROI. An interesting finding, even if we must remain cautious, as explained to us by Professor Stéphane Blanche, pediatrician at Necker Hospital in Paris and specialist in AIDS.
Listen to Professor Stéphane Blanche, pediatrician at Necker hospital: ” the authors hypothesize that the amount of virus embedded in the child’s DNA is so low that it will not cause infection in the future. It’s purely hypothetical, I think we have to be careful ”.
If these results hold true, the child born in Mississippi would be the second well-documented case of recovery in the world. The first is also American. Timothy Brown, said the Berlin patient, had been declared cured after a bone marrow transplant from a donor with a rare genetic mutation preventing the HIV virus from entering cells. However, this transplant was intended to treat leukemia. “For pediatrics, this is our Timothy Brown,” exclaimed Dr. Deborah Persaud. However, this practice is not without risk. Triple therapy remains toxic in a young child and can lead to metabolic disorders.
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