Baby with HIV 'functionally cured'

This is just about as exciting news for public health nerds as you can imagine: An HIV positive baby has apparently been cured, her HIV eradicated with very early, very aggressive anti-viral treatment.

The baby, born in rural Mississippi, was treated aggressively with antiretroviral drugs starting around 30 hours after birth, something that is not usually done. If further study shows this works in other babies, it will almost certainly be recommended globally. The United Nations estimates that 330,000 babies were newly infected in 2011, the most recent year for which there is data, and that more than three million children globally are living with H.I.V.

If the report is confirmed, the child born in Mississippi would be only the second well-documented case of a cure in the world. That could give a lift to research aimed at a cure, something that only a few years ago was thought to be virtually impossible, though some experts said the findings in the baby would probably not be relevant to adults.

The first documented case of a cure is the "Berlin patient" Timothy Brown who received a bone marrow transplant to cure his leukemia only to find out that he also received his donor's genetic resistance to HIV. This treatment, at least in infants, could be much more replicable.

One of the things the virus does very effectively is to find hiding places, lying dormant and hidden where anti-viral drugs can't reach it. Without permanent drug therapy, the virus can emerge. Current drugs in use can only hold the virus at bay, keeping it in hiding, essentially. But this case raises the possibility that the virus can be caught in infants before it finds those hiding places, before it builds up a large reservoir capable of destroying the immune system.

The case is leading researchers to question if adults could be diagnosed immediately after infection, they could be effectively cured with a similar treatment. The problem is, of course, getting to people immediately after infection. So this new case doesn't seem to provide an HIV cure for the majority of patients yet, but it's still huge news. At the very least, it could mean eradicating the virus in children. It could mean children born with the virus won't have to live their entire lives on drug therapy.