As news of a Mississippi, United States, US, baby girl who was functionally cured of HIV spread like wild fire last week, the world is again back on the threshold of history, panting for that golden moment, when man will declare a resounding victory over HIV/AIDS.
It will be the second time in five years that the world will get so close yet so far away from getting a cure for HIV/AIDS. Timothy Ray Brown, a gay American living in Germany, was the first living person to be functionally cured of the virus. It happened through an out-of-the box approach by Gero Hutter, then 37-year-old blood cancer specialist at the Charite Medical University, Berlin, Germany.
Speaking about the recent case, Deborah Persuad, a virologist with John Hopkins Children’s Center, Baltimore, Maryland, US said, “This is a proof of concept that HIV can be potentially curable in infants.”
The unnamed baby was born July 2010 to a mother who just tested HIV positive. Because the mother did not undergo standard prenatal anti-retroviral drugs, the baby was referred to the University of Mississippi Medical Center. There, Hannah Gay, a paediatric HIV specialist started the then 30-hour-old baby on three anti-retroviral drugs. Series of tests after that confirmed that indeed the baby has the infection and her ARV drugs were sustained.
By the time the baby turned 29 days, her viral level had become undetectable and she continued treatment for the next 18 months of her life. But after that, the mother stopped keeping appointments at the hospital only to reappear ten months later.
For Gay, the first step was to ask for HIV blood test to be conducted on the baby all over again. Surprisingly, the first and second test did not show any trace of the virus. “At that point, I knew I was dealing with a very unusual case,’’ said Gay.
But the specialist also enlisted the help of Katherine Luzuriaga, a colleague from the University of Massachusetts, US. The duo later supervised a number of sophisticated tests on the baby’s blood. They checked for traces of the virus, known as the silent reservoirs, but could not find any. Then they hunted for HIV DNA, which would show if the virus had been integrated into the virus of the infected person. Only very low levels of the virus showed up. Two tests also conducted on the viral RNA found only one copy of the virus.
As in the case of Brown, widely known as the Berlin patient, the latest development has chalked up commendations as well as criticisms in the medical world. While some called for further research and questioned how long the baby could remain free of HIV without anti-retroviral drugs, others have described it as a confirmation of the gains of anti-retroviral drugs when it is started early enough.
Anthony Fauci, director, National Institutes of Allergy and Infectious Diseases, US, whose agency has funded series of costly clinical trials on HIV vaccine is ecstatic. “With this case, it appears we may have not only a positive outcome for the particular child, but also a promising lead for additional research toward curing other children.’’
Despite the arguments, it is clear from Brown’s and the latest cases that science has turned a major bend in the search for a cure. However, it may ultimately take unconventional men like Hutter and perhaps other accidental cures to finally land man a permanent victory over the virus.