Molecular Medicine Israel

Cure for HIV-Infected Newborns?

A clinical trial will test the strategy a Mississippi doctor used to cure an infant

A treatment that previously eliminated HIV infection from a Mississippi infant will be tested in a clinical trial, Nature reported. Newborns with possible HIV infections will be given a course of three antiretroviral drugs in hopes of knocking down the virus before it has time to take hold.

The treatment was first successfully attempted in 2010, when an HIV-infected mother gave birth in Mississippi. Most HIV-infected women in the United States are given anti-retroviral drugs during pregnancy that greatly lessen the risk of passing on the infection to their children, but the Mississippi mother had not received prenatal care.

Under ordinary circumstances, infants born to HIV-positive women would only be given one or two anti-retroviral drugs until HIV tests came back. But because University of Mississippi Medical Center doctor Hannah Gay judged the infant to be at extraordinarily high risk, she administered a cocktail of three drugs immediately. The initial test given soon after birth indicated the child had been infected, but later tests showed that the treatment had eliminated the virus.

Now International Pediatric Adolescent Aids Clinical Trials (IMPAACT) Group is planning a formal clinical trial testing the strategy and hopes to start administering treatment to potentially infected newborns before the end of the year. The researchers will give the three-drug cocktail to at-risk infants and will add a fourth drug if the children test positive for HIV. When the children are around 3 years old, the researchers will test for viral particles and antibodies to HIV in their blood. If the children appear not to recognize the virus, the researchers will take them off the drugs and see if the virus returns.

The theory behind the treatment is that immature immune systems do not include many central memory T cells, where HIV infections take hold. Also, immature immune systems have a weaker inflammatory response than adult immune systems. Attacking the HIV virus quickly, before it has time to hole up in immune cells, may be key to preventing a permanent infection.

Researchers will present on the planned clinical trial at the International AIDS Society biennial meeting in Malaysia on June 29.

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