Watershed for HIV treatment

The Holy Grail of complete HIV cure still remains elusive, though there’s a glimpse of silver lining in the threatening horizon of this medical ‘death sentence’. In a remarkable feat, doctors in the United States, a team led by an Indian-origin virologist, Dr Deborah Persaud, have cured an infant of HIV which holds out hope for millions suffering from this deadly disease. This is the first documented case of effectively curing a child born with HIV with all such endeavours failing earlier, although a patient did manage to fully recover from this medical malady in 2007, though that involved a different procedure with stem cell transplant from a donor with rare genetic mutation that resists HIV. From a clinical perspective, this means that if an infected baby is put on antiretroviral drugs immediately after delivery, it is possible to prevent or reverse the infection – essentially cure the baby. This is a functional cure of an HIV-infected child which means that the standard tests are negative for the virus, but it is likely that a tiny amount remains in the body. The drugs given to the baby stopped the virus from replicating in short-lived, active immune cells and they also blocked the infection of other, long-lived white blood cells which can harbour HIV for years.The infant is now two and a half, and needs no further medicines for HIV. Until now children infected with HIV were given antiretroviral drugs with the intent to treat them for life The doctors believe that the infant has a normal life expectancy and is unlikely to be infectious to others. The baby has great chances for a long, healthy life and a similar outcome may be expected in many other high-risk babies.

The number of babies born with HIV in developed countries has fallen dramatically with the advent of better drugs and prevention strategies. Typically, women with HIV are given antiretroviral drugs during pregnancy to minimise the amount of virus in their blood. Their newborns go on courses of drugs too, to reduce their risk of infection further. The strategy can stop around 98 per cent of HIV transmission from mother to child. The problem is far more serious in developing countries. India is currently experiencing a concentrated HIV epidemic. The sex workers, injecting drug users, men having sex with men and transgender persons remain most at risk of HIV infections. The current estimate of HIV/AIDS patients is 2.39 million in 2009, with an adult prevalence of 0.31 per cent of the total population in India. However, on a positive note, HIV prevalence has seen a sharp reduction in the last ten years (2.76 million in 2000, with an adult prevalence of 0.41 per cent). In a similar vein, new HIV infections have witnessed a 50 per cent reduction in the last 10 years, from 2.7 lakh in 2000 to 1.2 lakh in 2009. In sub-Saharan Africa, around 387,500 children aged 14 and under were receiving antiretroviral therapy in 2010 and many of these were born with the infection. However, until scientists better understand how they cured this US child, prevention remains the most reliable way to stop babies contracting the virus from infected mothers. Scientists say it will take a lot more research and much more sensitive diagnostics before the hope of eradicating the virus in young children becomes a reality.