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Posts tagged ‘Deborah Persaud’

Second HIV Baby in Study Free of Virus.


Two children with HIV who were treated immediately after birth have no signs of the virus 9 and 23 months later, scientists said in a report that suggests a potential approach to curing HIV-infected babies.

The findings from the two children are spurring doctors in Canada, South Africa and the U.S. to try to replicate the results, and spawned a study in 54 babies, the researchers said yesterday.

The research suggests that deploying drugs early in life may help keep the virus from gaining a foothold. The importance of such a result is clear: More than 260,000 children were infected globally with HIV in 2012, either at birth or through breastfeeding.

While the early findings are promising, a final step is needed before determining that a cure is at hand, said Deborah Persaud, an associate professor of infectious diseases at the Johns Hopkins University School of Medicine in Baltimore.

“The only way we can prove that we’ve accomplished remission in these kids is taking them off treatment, and that’s not without risks,” Persaud, who was involved in the research on both babies, said in an interview yesterday at a medical meeting on infectious disease held in Boston.

While the latest HIV drugs can keep the virus in check, they don’t eliminate it from hidden reservoirs deep within the body. The drugs are taken for a lifetime and patients often have to cycle among different medicines to offset the disease’s ability to become resistant.

Los Angeles Baby

Persaud presented results yesterday from a child born last year in Los Angeles County. The baby began treatment with anti- HIV drugs four hours after being born and still has no trace of the virus in its blood, Persaud said. The baby remains on treatment, and there’s no immediate plan to stop the medicine to see whether the virus rebounds, she said.

The previous child, born in Mississippi, was cleared of the virus with a similar approach a year ago, and remains HIV-free 23 months after ceasing treatment, according to Persaud, who presented her report yesterday at the annual Conference on Retroviruses and Opportunistic Infections.

Inspired by the Mississippi baby, doctors in Canada are now seeking to repeat the result in five newborns, and three babies in South Africa are also receiving medicines in an effort to cure them. Within the next few months, researchers also plan to start a trial in 54 children to test whether the approach can be repeated on a larger scale, Persaud said.

That larger study will start infected infants on treatment within 48 hours of birth, then take them off drugs two years later to see whether the virus rebounds.

Drug Combination

The babies will receive a three-drug combination of zidovudine and lamivudine, two now-generic medicines developed by GlaxoSmithKline Plc, and nevirapine, a treatment from Boehringer Ingelheim GmbH that has also lost patent protection.

The cases involving the two infants build on increasing evidence about approaches to curing a disease doctors once thought an insurmountable challenge.

To date, the only adult to have been cured of the virus is Timothy Ray Brown, the so-called Berlin patient. Brown has been clear of the virus since having a bone marrow transplant for leukemia in 2007 from a donor with a rare mutation to a gene called CCR5 that keeps HIV at bay without the aid of antiretroviral drugs.

While the case proves that HIV can be cured, bone marrow transplants are too expensive and dangerous to make them practical on a mass scale.

Sangamo Biosciences Inc. is trying to mimic the CCR5 mutation with a gene-altering technology. In a study published yesterday in the New England Journal of Medicine, researchers led by Carl June at the University of Pennsylvania infused 12 patients with Richmond, California-based Sangamo’s SB-728-T, an experimental treatment that changes CCR5.

While the trial was designed to assess the product’s safety, not its efficacy, it found that the treatment was associated with a drop in the amount of virus in some patients who were taken off their regular anti-AIDS drugs.

 

© Copyright 2014 Bloomberg News. All rights reserved.
Source: Newsmax.com

Scientists say baby born with HIV apparently cured.


RELATED CONTENT

  • This image released by the University of Mississippi Medical Center shows Dr. Hannah Gay, a pediatric HIV specialist at the University of Mississippi, Friday, March 1, 2013. A baby born with the AIDS virus appears to have been cured, scientists announced Sunday, March 3, 2013, describing the case of a child from Mississippi who's now 2½ and has been off medication for about a year with no signs of infection. "I just felt like this baby was at higher-than-normal risk, and deserved our best shot," said Gay. (AP Photo/ University of Mississippi Medical Center, Jay Ferchaud)View PhotoThis image released by the University …
  • This image provided by Johns Hopkins Medicine shows Dr. Deborah Persaud of Johns Hopkins' Children's Center in Baltimore. A baby, born with the AIDS virus, appears to have been cured scientists announced Sunday, March 3, 2013, describing the case of a child from Mississippi, who's now 2½ and has been off medication for about a year with no signs of infection. If the child remains free of HIV, it would mark only the world's second known cure. Specialists say the finding offers exciting clues for how to eliminate HIV infection in children. "Maybe we'll be able to block this reservoir seeding," Persaud said. (AP Photo/Johns Hopkins Medicine)View PhotoThis image provided by Johns Hopkins …

WASHINGTON (AP) — A baby born with the virus that causes AIDS appears to have been cured, scientists announced Sunday, describing the case of a child from Mississippi who’s now 2½ and has been off medication for about a year with no signs of infection.

There’s no guarantee the child will remain healthy, although sophisticated testing uncovered just traces of the virus’ genetic material still lingering. If so, it would mark only the world’s second reported cure.

Specialists say Sunday’s announcement, at a major AIDS meeting in Atlanta, offers promising clues for efforts to eliminate HIV infection in children, especially in AIDS-plagued African countries where too many babies are born with the virus.

“You could call this about as close to a cure, if not a cure, that we’ve seen,” Dr. Anthony Fauci of the National Institutes of Health, who is familiar with the findings, told The Associated Press.

A doctor gave this baby faster and stronger treatment than is usual, starting a three-drug infusion within 30 hours of birth. That was before tests confirmed the infant was infected and not just at risk from a mother whose HIV wasn’t diagnosed until she was in labor.

“I just felt like this baby was at higher-than-normal risk, and deserved our best shot,” Dr. Hannah Gay, a pediatric HIV specialistat the University of Mississippi, said in an interview.

That fast action apparently knocked out HIV in the baby’s blood before it could form hideouts in the body. Those so-called reservoirs of dormant cells usually rapidly reinfect anyone who stops medication, said Dr. Deborah Persaud of Johns Hopkins Children’s Center. She led the investigation that deemed the child “functionally cured,” meaning in long-term remission even if all traces of the virus haven’t been completely eradicated.

Next, Persaud’s team is planning a study to try to prove that, with more aggressive treatment of other high-risk babies. “Maybe we’ll be able to block this reservoir seeding,” Persaud said.

No one should stop anti-AIDS drugs as a result of this case, Fauci cautioned.

But “it opens up a lot of doors” to research if other children can be helped, he said. “It makes perfect sense what happened.”

Better than treatment is to prevent babies from being born with HIV in the first place.

About 300,000 children were born with HIV in 2011, mostly in poor countries where only about 60 percent of infected pregnant women get treatment that can keep them from passing the virus to their babies. In the U.S., such births are very rare because HIV testing and treatment long have been part of prenatal care.

“We can’t promise to cure babies who are infected. We can promise to prevent the vast majority of transmissions if the moms are tested during every pregnancy,” Gay stressed.

The only other person considered cured of the AIDS virus underwent a very different and risky kind of treatment — a bone marrow transplant from a special donor, one of the rare people who is naturally resistant to HIV. Timothy Ray Brown of San Francisco has not needed HIV medications in the five years since that transplant.

The Mississippi case shows “there may be different cures for different populations of HIV-infected people,” said Dr. Rowena Johnston of amFAR, the Foundation for AIDS Research. That group funded Persaud’s team to explore possible cases of pediatric cures.

It also suggests that scientists should look back at other children who’ve been treated since shortly after birth, including some reports of possible cures in the late 1990s that were dismissed at the time, said Dr. Steven Deeks of the University of California, San Francisco, who also has seen the findings.

“This will likely inspire the field, make people more optimistic that this is possible,” he said.

In the Mississippi case, the mother had had no prenatal care when she came to a rural emergency room in advanced labor. A rapid test detected HIV. In such cases, doctors typically give the newborn low-dose medication in hopes of preventing HIV from taking root. But the small hospital didn’t have the proper liquid kind, and sent the infant to Gay’s medical center. She gave the baby higher treatment-level doses.

The child responded well through age 18 months, when the family temporarily quit returning and stopped treatment, researchers said. When they returned several months later, remarkably, Gay’s standard tests detected no virus in the child’s blood.

Ten months after treatment stopped, a battery of super-sensitive tests at half a dozen laboratories found no sign of the virus’ return. There were only some remnants of genetic material that don’t appear able to replicate, Persaud said.

In Mississippi, Gay gives the child a check-up every few months: “I just check for the virus and keep praying that it stays gone.”

The mother’s HIV is being controlled with medication and she is “quite excited for her child,” Gay added.

Source: YAHOO NEWS.

By LAURAN NEERGAARD | Associated Press

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