Posted on July 10, 2014
Source: Johns Hopkins School of Medicine
The 4-year-old Mississippi child whose HIV infection was put in remission with pre-emptive anti-viral treatment shortly after birth has shown signs of viral recurrence, according to the team that has been following the patient since birth. That team includes Deborah Persaud, M.D., a pediatric HIV specialist at the Johns Hopkins Children’s Center, who performed the initial and all subsequent virological analyses on the case; Hannah Gay, M.D., a pediatrician at the University of Mississippi Medical Center who has been treating and following the child since birth; and immunologist Katherine Luzuriaga, M.D., of the University of Massachusetts Medical School, who conducted immunological monitoring of the child.
In light of the new findings, the child has started anti-retroviral therapy, is doing well and has had excellent response to the treatment. The child remains under the medical care of Gay at the University of Mississippi Medical Center.
Persaud and colleagues described the latest development as decidedly disappointing, but they say the case remains a medical first and a significant milestone in pediatric HIV research.
“This is a definite setback on our quest to eradicate HIV, but we are not discouraged,” Persaud says. “This latest development highlights how much more we still have to learn about HIV and its hideouts. Nonetheless, achieving full remission for more than two years in the absence of treatment represents an important medical advance that has given us critical insights and illuminated important new questions.”
Described as the first documented instance of HIV remission in a child, the Mississippi case invigorated the field of HIV research by suggesting that very early treatment with anti-retroviral drugs may help quash the formation of viral reservoirs — HIV hideouts that remain unreachable for antiviral drugs and preclude HIV clearance in the majority of patients. Typically, HIV infection is reignited full blast within mere weeks of stopping treatment. By contrast, the Mississippi child remained free of active infection, with undetectable viral loads and free of HIV antibodies for more than two years.
