Toddler Born with HIV Still Infection Free 18 Months After Ending Treatment

A three-year-old born with HIV and treated with a combination of antiviral drugs is still free of active infection 18 months after treatment ended. Published in the New England Journal of Medicine, the report outlining the case represents the first documented case of HIV remission in a child.

"Our findings suggest that this child's remission is not a mere fluke but the likely result of aggressive and very early therapy that may have prevented the virus from taking a hold in the child's immune cells," Dr. Deborah Persaud, lead author of the report and a virologist and pediatric HIV expert at the Johns Hopkins Children's Center, said in a statement.

Born to an HIV-infected mother, the child began antiretroviral treatment 30 hours after birth, with a series of tests in the following days and weeks revealing a progressive lessening of the virus in the child's blood. The child remained on antivirals until it was 18 months old, despite reaching undetectable viral levels at 29 days. Treatment stopped because the "child was lost to follow-up for a while," the new release outlining the report states. Repeated testing 10 months after treatment ended revealed no amount of virus in the blood.

"We're thrilled that the child remains off medication and has no detectable virus replicating," said Dr. Hannah Gay, a physician from the University of MIssissippi Medical Center who identified and treated the baby. "We've continued to follow the child, obviously, and she continues to do very well. There is no sign of the return of HIV, and we will continue to follow her for the long term."

The investigators believe the prompt administration of antiviral treatment halted the formation of viral reservoirs that are difficult to treat, such as viruses that hide out in immune cells until drug therapy stops, at which point they frequently reignite the infection.

"Prompt antiviral therapy in newborns that begins within hours or days of exposure may help infants clear the virus and achieve long-term remission without the need for lifelong treatment by preventing such viral hideouts from forming in the first place," Persaud said.

A federally funded study set to begin in 2014 will examine the early-treatment method used in this case in order to determine whether it should be used to treat all HIV-infected newborns.