Last year scientist announced that a baby born with H.I.V. had been cured of the disease with an aggressive drug treatment started 30 hours after birth.
There was doubt that the child had been infected at all, until an announcement on Wednesday at an AIDS conference. A second baby was revealed to be apparently free of the virus that cause AIDS, leaving no doubt that the treatment works. Researchers are saying there might be five more such cases in Canada and three in South Africa.
According to a researcher, a clinical trial for about 60 babies who are born infected with H.I.V. will be put on the drugs within 48 hours will be set to begin soon. If the trial works, the obligation for treating the 250,000 babies born infected each year worldwide would definitely change. “This could lead to major changes, for two reasons,” said Dr. Anthony S. Fauci, executive director of the National Institute for Allergy and Infectious Diseases. “Both for the welfare of the child, and because it is a huge proof of concept that you can cure someone if you can treat them early enough.”
That was the third piece of hopeful news in two days about the virus that causes AIDS. Scientists reported on Tuesday that injections of long lasting AIDS drugs, fended off the infection in monkeys, and on Wednesday, researchers announced a “gene editing” advance that will probably enable immune cells to repel the virus. The Mississippi baby, the first infant to make a recovery from H.I.V. was described last March at a Conference on Retroviruses and Opportunistic Infections, now at the same annual conference, the news of the new case was reported on Wednesday.
According to Dr. Deborah Persaud, a virologist who runs ultrasensitive tests on both children in her lab, at the John Hopkins Children’s Center in Baltimore said the Mississippi child now three years old, is still living virus free.
The second baby was born at Miller Children’s Hospital in Long Beach, California. She is now 9 months old and living free of the H.I.V. virus. Four hours after the birth, Dr. Audra Deveikis, a pediatrician drew the baby’s blood for an H.I.V. test and started three drugs, AZT, 3TC and nevirapine at high doses.
“Of course I had worries,” Dr. Deveikis said in an interview. “But the mother’s disease was not under control, and I had to weigh the risk of transmission against the toxicity of the meds, I heard of the Mississippi baby, I watched the video she added. I knew that if you wanted to prevent infection, early treatment is critical.”
The virus began to disappear six days after birth and was undetectable within 11 days. It would be medically unethical to stop giving the baby the drugs now, but Dr. Deveikis and Dr. Yvonne J. Bryson, a pediatric AIDS expert at the University of California, Los Angeles, said they would consider stopping them briefly to see what happens if the baby is still virus free at the age of two.
There will be three investigators who will be seeking 60 babies for a clinical trial. Dr. Bryson will be one of the three investigating. Doctors in the United States, South Africa and Brazil will be on watch for babies being born to mothers who don’t take the mother-child transmission drugs, so they can start antiretroviral treatment immediately.
Although antiretrovirals prevent the virus from replicating, s small amount usually persists in reservoirs throughout the body, integrated into the DNA of cells. Dr. Persaud’s test can activate those cells and force them to “spit out” the virus, where it can be detected.
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