HIV baby's 'functional cure' doesn't change research reality

March 5, 2013 | by Tami Dennis

A baby born with HIV has been “functionally cured” of the virus, reported her doctors – and a host of media outlets – this week.

 

A Mississippi girl has reportedly been "functionally cured" of HIV, with her body now able to resist the virus on its own. Here, HIV is shown in the bloodstream. A Mississippi girl has reportedly been "functionally cured" of HIV, with her body now able to resist the virus on its own. Here, HIV is shown in the bloodstream.

 

The child, who began an aggressive regimen of anti-retroviral drugs soon after birth, is now 2 years old and has only traces of HIV, the virus that causes AIDS, in her bloodstream. The traces are so faint, in fact, that her body is able to control the virus on its own, meaning she no longer needs medication.

The promise is hard to ignore.

If a functional cure can be achieved in other infants, the outlook for global health could shift significantly. More than 3 million children worldwide have HIV, with the United Nations estimating that 330,000 babies were infected in 2011 alone.

As the New York Times noted, if the report is confirmed, the child will be only the second well-documented cure. The first was the so-called Berlin patient, a middle-aged man who received a bone marrow transplant for leukemia from a donor known to be genetically resistant to HIV.

Some experts have greeted the recent reports of a cure skeptically. Others have said that, even if the child has been able to overcome HIV infection, such a breakthrough isn’t especially relevant for treatment of adult infections. Adults are simply diagnosed too late.

“The treatment of the Mississippi girl appears to have threaded the needle between bloodstream infection and permanent seeding of the memory T cells. Achieving that in adults, most of whom acquire HIV through sexual contact without knowing it, is exceedingly difficult,” wrote the Washington Post.

Added the Wall Street Journal: “It isn't clear how the new case applies to people with established infections. Such infections are characterized by 'viral reservoirs' where HIV lurks in immune-system cells, hidden from treatment and ready to roar back when treatment stops. The latent reservoirs persist for years and are the major barrier to an overall cure of HIV and AIDS.”

Thus the amount of work to be done is also hard to ignore.

Noted City of Hope’s John Zaia, M.D., the Aaron D. and Edith Miller Chair in Gene Therapy and the chair of the Department of Virology, somewhat wryly: “One swallow does not a summer make.”

To that end, the research continues – at City of Hope and elsewhere. Here, researchers are exploring RNA interference-based gene therapy and the possibilities of targeting what’s known as a CCR5 receptor. That receptor plays a role in helping HIV infect cells, as this New York Times story explained.

Commented HIV/AIDS expert John J. Rossi, Ph.D., the Lidow Family Research Chair at City of Hope and chair of the Department of Molecular and Cellular Biology, on the 30th anniversary of the discovery of AIDS: "I now envision AIDS as a disease we will successfully combat — like we have successfully combated smallpox and polio. I believe that is possible."

Thus, hope continues as well. Perhaps that's the most important element in this week's news.

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