Child cured of HIV: Can this be repeated?

Abstract

Eradication of HIV infection is the most challenging research area in the HIV/AIDS field. Treatment of HIV infection with antiretrovirals halts viral replication but fails to eradicate infection because it does not eliminate latent viruses. Eradication has only been achieved in one exceptional case after bone marrow transplantation. For this reason, researchers were surprised by a report describing the first cure of an HIV-infected individual using antiretrovirals. It was an in utero HIV-infected newborn treated immediately after birth with a potent antiretroviral combination. After treatment interruption, the child showed no evidence for active HIV infection; she was apparently cured. The case is particular and can be seen as an extreme case of postexposure prophylaxis. Moreover, due to strong immunological differences between newborns and adults, the case does not provide new hope for adult HIV-infected individuals, although it may open new treatment standards for functional cure of HIV-infected newborns. However, new studies to proof the benefit of immediate treatment of HIV-exposed newborns will require the definition of point of care diagnostic tools, drug regimens and the minimal time from birth to therapy introduction, and also importantly, when and under what settings should treatment be interrupted to test for functional cure. © 2013 Informa UK, Ltd.