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Author Topic: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs  (Read 32077 times)

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Offline John2038

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Sources:
bloomberg
eurekalert
npr

Doctors say they have cured an infant born with HIV for the first time by giving her a cocktail of drugs shortly after birth, a result that could point the way toward saving the lives of thousands more infected children.

At 18 months, the mother took the child off the medication. With no signs of the virus for 10 months, the infant was deemed “functionally cured,” researchers said.

Offline Dr.Strangelove

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #1 on: March 03, 2013, 08:24:20 pm »
Here's the abstract on the CROI website: link

It's nice to see another case of 'cure'. This sends out the message to the public that there is some progress with HIV research.
On the other hand, I don't think this is a game changer. It's only applicable to people who are at the onset of seroconversion.

Offline OneTampa

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #2 on: March 03, 2013, 08:30:03 pm »
Here also is a Huffington Post article listed 1 hour ago through AOL:

http://www.huffingtonpost.com/2013/03/03/baby-cured-of-hiv_n_2803041.html?icid=maing-grid7|main5|dl1|sec1_lnk1%26pLid%3D278007
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Offline Newguy

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #3 on: March 03, 2013, 09:59:31 pm »
To me it is a game changer. To get to number 40 million you must pass number 2 first.

Best

Here's the abstract on the CROI website: link

It's nice to see another case of 'cure'. This sends out the message to the public that there is some progress with HIV research.
On the other hand, I don't think this is a game changer. It's only applicable to people who are at the onset of seroconversion.

Offline sam66

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #4 on: March 03, 2013, 11:03:32 pm »


     Good news, another step forward!
december 2007 diagnosed +ve ,

Offline Jmarksto

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #5 on: March 03, 2013, 11:27:20 pm »
I agree, it is great from a personal perspective for the infant and their family, and it is great for the public to see the possibilities.

I guess what strikes me is that we have two people cured, and both of them through clinical, as opposed to the major research, methods.  I recognize that the major research efforts have played a role - but these haven't been through major research projects. Having said that, I also recognize that researchers would not have been able to interrupt treatment the way it seems to have been in this case to observe these results.

I hope this breaths some fresh air into the research efforts.

JM
« Last Edit: March 03, 2013, 11:58:53 pm by Jmarksto »
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Offline tednlou2

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #6 on: March 04, 2013, 12:12:36 am »
Is this not the same as an adult taking PEP?  You may prevent the infection, and may not.

Offline Newguy

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #7 on: March 04, 2013, 12:22:37 am »
Is this not the same as an adult taking PEP?  You may prevent the infection, and may not.

I don't think it is the same. I believe she had the virus in her already when they started her on therapy. Don't quote me but I believe newborns don't have the same developed immune system as adults so it might be possible that long term memory cells were not seeded when she started therapy. This is why she cleared the infection. I believe they recently discovered that the majority hide out in the lymph tissue specifically in the germ layers and current drugs can not penetrate this tissue yet.

Best

Offline YellowFever

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #8 on: March 04, 2013, 01:49:57 am »
Interesting news. But we'll need to wait for the actual presentation on CROI. We don't know conclusively if the baby was infected in the first place as babies could be tested positive for their mother's HIV antibodies. So it will be interesting to hear what sort of data she will be presenting!
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Offline Common_ground

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #9 on: March 04, 2013, 02:08:28 am »
Interesting news. But we'll need to wait for the actual presentation on CROI. We don't know conclusively if the baby was infected in the first place as babies could be tested positive for their mother's HIV antibodies. So it will be interesting to hear what sort of data she will be presenting!

Tests of the babys blood showed some 20,000 copies/ml of HIV right after birth.
5 tests, 4 RNA and 1 DNA were all positive for HIV.

http://www.nytimes.com/2013/03/04/health/for-first-time-baby-cured-of-hiv-doctors-say.html
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Offline littleprince

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #10 on: March 04, 2013, 03:18:37 am »
There was a member on these forums about a year ago who started HAART immediately after they had a high risk infection event. They ended up being infected but they couldn't test positive in a normal HIV test because they had medication so early (days?).

Does anyone remember this. To me this sounds similar. Could it be that there are other 'functionally cured' people out there? Maybe this should be the treatment for medical workers for example who have a high risk event. They take PEP for longer than a month.

Offline sensual1973

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #11 on: March 04, 2013, 04:54:42 am »
Good news,but how would that be of a benefit to us the already infected?.
God grant me the serenity to accept the things i can not change.

Offline YellowFever

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #12 on: March 04, 2013, 05:04:25 am »
Good news,but how would that be of a benefit to us the already infected?.

Stigma.

I hope that there is enough evidence that can prove that if HIV is detected and treated immediately, it can be cured. So had a night of barebacking? No problem, walk into the doctor's office tomorrow, get monitored for HIV RNAs over the next few days, start treatment for X amount of time and be cured.

Like PEP but goes one step further to say that cure can be achieved even with an infection.

*Cure here of course refers to a functional cure. But I chose to use the 4 letter word on its own.
« Last Edit: March 04, 2013, 05:08:39 am by YellowFever »
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Offline red_Dragon888

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #13 on: March 04, 2013, 06:56:53 am »
Wasn't there a story of a gay male couple who had an adopted nine year old son, who was born with HIV, taken away when the same child suddenly tested negative for HIV some years ago.
http://www.youtube.com/watch?feature=player_embedded&v=I3ba3lnFHik

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Offline Ann

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #14 on: March 04, 2013, 08:09:07 am »
Sources:
bloomberg
eurekalert
npr

Doctors say they have cured an infant born with HIV for the first time by giving her a cocktail of drugs shortly after birth, a result that could point the way toward saving the lives of thousands more infected children.

At 18 months, the mother took the child off the medication. With no signs of the virus for 10 months, the infant was deemed “functionally cured,” researchers said.

John, your links are broken.

bloomberg

eurekalert

npr

Fixed!

We may have been utilising this cure for ages now, in the form of PEP.

The main difference between adults who are given PEP and this baby is that they ran a viral load test on the baby soon after birth, and got those results soon after.

The baby had a viral load and this seems to be what prompted the pediatrician (Dr. Gay) to put the baby on combo therapy, rather than the standard AZT monotherapy for six weeks.

When an adult accesses PEP after a true risk with a known hiv positive person, the only test run is an antibody test in order to ensure they were hiv negative before the risk for which they are seeking PEP. Viral load tests are not run at this point.

So I have to wonder, if viral load tests were run on adults seeking PEP, particularly if they present in the latter stages of the 72 hour PEP window, how many of them would have a viral load just like the baby did?

It's quite rare for a person who has had a true risk who initiates PEP within the 72 hour window to end up hiv positive.

Do you see what I'm getting at? I think this isn't actually an isolated case of a "functional cure". I think it's quite possible we've been doing this for years now and just didn't see it for what it is. 

I wonder what prompted her doctors to run a VL test so soon after birth. It's not standard practice. At least it wasn't the last time I studied mother-to-child testing protocol (not that long ago). This (viral load testing and combo treatment for those who have a detectable VL) may well be the way forward for stopping infections in babies born to mothers who lacked prenatal care.

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Offline YellowFever

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #15 on: March 04, 2013, 09:42:56 am »
Ann,

do you have a link somewhere to read that protocol? I'd like to know the rationale behind antibody testing only (even for adults). Its seems intuitive to me to monitor VLs for a while even if UD for new borns after birth. Of course, in adults, post-exposure, this could add up to a huge waste in resources. Or is this just hindsight 20/20?
08/2010 HIV- 08/2012 HIV+
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Offline Ann

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #16 on: March 04, 2013, 10:05:55 am »
Ann,

do you have a link somewhere to read that protocol? I'd like to know the rationale behind antibody testing only (even for adults). Its seems intuitive to me to monitor VLs for a while even if UD for new borns after birth. Of course, in adults, post-exposure, this could add up to a huge waste in resources. Or is this just hindsight 20/20?

You can find the American guidelines at http://www.aidsinfo.nih.gov/guidelines/

You can find the British guidelines (which are pretty much the same across Europe) at http://i-base.info/guides/pregnancy and http://www.aidsmap.com/Treatment-for-women/cat/1467/

BTW, it's difficult to draw large quantities of blood from a newborn. They have to go into the foot, usually the heel. It's not a pleasant experience for the baby.

VL test results usually have a long turn-around time, up to two weeks. This is because VL tests are usually run in batches, because it's an expensive procedure. That's why they're not routinely used for adults presenting for PEP. By the time the VL results came back, it would be too late to start PEP.

What has me curious is 1) why did they run a VL test on this newborn and 2) how did they get the results so quickly. It's odd.
« Last Edit: March 04, 2013, 10:10:09 am by Ann »
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline mecch

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #17 on: March 04, 2013, 10:44:56 am »

We may have been utilising this cure for ages now, in the form of PEP.

The main difference between adults who are given PEP and this baby is that they ran a viral load test on the baby soon after birth, and got those results soon after.

The baby had a viral load and this seems to be what prompted the pediatrician (Dr. Gay) to put the baby on combo therapy, rather than the standard AZT monotherapy for six weeks.


I agree is seems conceptually similar to PEP, but also there are differences... The details emerging are not clear, and far from complete.  Why was the baby on HAART for 18 months?   This is not similar to PEP, than, obviously....  Were there viral loads done during the 18 months that proved there was an established infection?   

The leaps in flawed logic and hopes in the articles online today, cure CURE CURE!!! - are what they are.  If there is a need to tweak how to treat babies born to HIV+ mothers, that's great, but are't most of these treatments successful, and stopped shortly afterwards.. They aren't "cures"..  Did this particular baby even need 18 months of HAART?

I do like the observation that this baby and the Berlin patient are results of interesting clinical decisions....    Surely many advances in HIV treatment we've enjoyed have been through clinical practice just as much as research...   


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.


http://www.huffingtonpost.com/2013/03/03/baby-cured-of-hiv_n_2803041.html?icid=maing-grid7
« Last Edit: March 04, 2013, 10:50:38 am by mecch »
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Offline Matts

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #18 on: March 04, 2013, 11:14:04 am »
Two men in Boston are maybe "cured" after bone marrow transplants (without CCR5) ,too. They would be Number 3 and 4 :)

http://www.cbsnews.com/8301-504763_162-57481578-10391704/bone-marrow-transplant-eliminates-hiv-traces-from-two-patients-dna-call-it-a-cure/
Dovato

Offline Ann

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #19 on: March 04, 2013, 11:41:08 am »

Why was the baby on HAART for 18 months?   This is not similar to PEP, than, obviously....  Were there viral loads done during the 18 months that proved there was an established infection?   

Did this particular baby even need 18 months of HAART?


You obviously neglected to read the NY Times article previously linked to...

Tests of the babys blood showed some 20,000 copies/ml of HIV right after birth.
5 tests, 4 RNA and 1 DNA were all positive for HIV.

http://www.nytimes.com/2013/03/04/health/for-first-time-baby-cured-of-hiv-doctors-say.html

Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Larsen

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #20 on: March 04, 2013, 02:09:16 pm »
It strikes me that there is an awful lot of very shaky extrapolation and dubious claims being made about this case; not to mention that the reporting - on the basis of nothing more than a press conference and a sketchy and less than convincing abstract - is shamefully imprecise and riddled with quite fundamental errors. Added to that we have the issue that none of this child's blood samples have been retained for further examination.

I am far from convinced that this is evidence of anything even remotely close to what it is being hyped as .. especially so considering the extreme difficulty in reliably diagnosing HIV in a newborn baby, with an immature immune system, that is still heavily reliant on the temporary passive immunity offered by its mother's antibodies.
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Offline Larsen

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #21 on: March 04, 2013, 03:22:56 pm »
The baby had a viral load and this seems to be what prompted the pediatrician (Dr. Gay) to put the baby on combo therapy, rather than the standard AZT monotherapy for six weeks.

This is one of the things that bothers me, because as far as I can see from the reading of the guidelines (and of course I could be wrong), AZT monotherapy wouldn't even be the standard neonatal prophylaxis for a baby born under those circumstances - it would be at least AZT given for 6 weeks combined with three doses of nevirapine, with the option to add more drugs if appropriate (so at least two of the three drugs that the baby was actually given). Whilst admittedly not necessarily fundamental, it is the sort of thing that makes me question the veracity of the presentation of the case and 'facts'.

The section of guideline I am reading:

Quote
  • Infants born to HIV-infected women who have not received antepartum antiretroviral (ARV) drugs should receive prophylaxis with zidovudine given for 6 weeks combined with three doses of nevirapine in the first week of life (at birth, 48 hours later, and 96 hours after the second dose), begun as soon after birth as possible (AI).
  • In other scenarios, the decision to combine other drugs with the 6-week zidovudine regimen should be made in consultation with a pediatric HIV specialist, preferably before delivery, and should be accompanied by counseling of the mother on the potential risks and benefits of this approach
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Offline Souledout

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #22 on: March 04, 2013, 03:40:29 pm »
John, your links are broken.

bloomberg

eurekalert

npr

Fixed!

We may have been utilising this cure for ages now, in the form of PEP.

The main difference between adults who are given PEP and this baby is that they ran a viral load test on the baby soon after birth, and got those results soon after.

The baby had a viral load and this seems to be what prompted the pediatrician (Dr. Gay) to put the baby on combo therapy, rather than the standard AZT monotherapy for six weeks.

When an adult accesses PEP after a true risk with a known hiv positive person, the only test run is an antibody test in order to ensure they were hiv negative before the risk for which they are seeking PEP. Viral load tests are not run at this point.

So I have to wonder, if viral load tests were run on adults seeking PEP, particularly if they present in the latter stages of the 72 hour PEP window, how many of them would have a viral load just like the baby did?

It's quite rare for a person who has had a true risk who initiates PEP within the 72 hour window to end up hiv positive.

Do you see what I'm getting at? I think this isn't actually an isolated case of a "functional cure". I think it's quite possible we've been doing this for years now and just didn't see it for what it is. 

I wonder what prompted her doctors to run a VL test so soon after birth. It's not standard practice. At least it wasn't the last time I studied mother-to-child testing protocol (not that long ago). This (viral load testing and combo treatment for those who have a detectable VL) may well be the way forward for stopping infections in babies born to mothers who lacked prenatal care.

It was my understanding that by the time you get your viral spike and HIV in the bloodstream then PEP will not work. There are a few days when the virus is only present in the localised lymph nodes near to the primary infection point before it "bursts" out, into the blood stream. PEP after this point will stop the virus replicating but not infecting the rest of the body. This window period is around 3 days, hence why PEP is only given in that time. This baby had high levels of virus in the blood already. So I don't think that this is quite the same as PEP... (that's assuming it's all true also)(I did read somewhere else that viral load tests are routine on new borns as antibody tests can pick up the mothers antibodies).

I'm basing this on articles I read in my newly infected stage when I wasn't sure I gad been caught pre or post spike. I read A LOT back then and for the life of me I can't find the article I read on very early HIV pathogenesis, otherwise I'd link to it.
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Offline mikeyb39

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HIV cure for newborn baby
« Reply #23 on: March 04, 2013, 06:39:54 pm »
Is this something new or am I missing something.   PEP?  This seems all over the news, but this has been what PEP has been used for in a while.

call me when they find a functional cure for those of us living with it currently.
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Offline buginme2

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #24 on: March 04, 2013, 10:23:26 pm »
wow it's tough to be a baby cured of teh aids in this room.

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Offline Jeff G

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #25 on: March 04, 2013, 10:39:56 pm »
wow it's tough to be a baby cured of teh aids in this room.



I agree . My heart goes out to this child , she is 2 years old and surely has endured test after test and it wouldn't surprise me if there are more to come . I hope she is treated with the dignity all children deserve and not subjected to a childhood of needles and endless test .
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Offline Growler

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #26 on: March 04, 2013, 11:41:25 pm »
“If loving someone is putting them in a straitjacket and kicking them down a flight of stairs, then yes, I have loved a few people.”

Offline Larsen

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #27 on: March 05, 2013, 12:49:27 am »
I don't think it is the same. I believe she had the virus in her already when they started her on therapy. Don't quote me but I believe newborns don't have the same developed immune system as adults so it might be possible that long term memory cells were not seeded when she started therapy. This is why she cleared the infection.

Exactly, I suspect that the working postulation is that a newborn with an immature immune system doesn't actually have any (or very many) of its own dormant memory CD4 T cells to infect and that by hitting the HIV hard at that stage effectively eliminates it before you enter into the 60 year (or whatever it is) cycle it would take to clear the virus through drugs alone.

Which is where Ann's point comes in. Is the fortuitous event actually that this child was given different treatment, is it that the mother withdrew the child from treatment, or is it a combination of the two? My reading of it is that even with this different treatment, the child would have been left on drugs for the rest of its life, had it not been for the fact that the mother withdrew it from treatment; which makes you wonder if there are similar kids out there who we just assume are living with an undetectable viral load, thanks to ongoing ARV therapy.
« Last Edit: March 05, 2013, 12:56:14 am by Larsen »
In a far better p[lace than this minging shithole

Offline tednlou2

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #28 on: March 05, 2013, 01:20:58 am »
Wasn't there a story of a gay male couple who had an adopted nine year old son, who was born with HIV, taken away when the same child suddenly tested negative for HIV some years ago.

Yes.  I remember seeing them in a documentary.  I think Rosie O'Donnell got involved.  The HIV poz kids were not deemed adoptable in Florida.  Once the boy no longer tested poz, he was considered adoptable.  And, Florida bans gay parents from adopting. 

I have been thinking the same as Larsen.  I wonder how many kids are out there still believing they are poz, when they may have cleared the virus, as this kid apparently has.  Dr. Fauci gave an interview saying it is premature to say this kid is "cured."  He warned the virus could be asleep in some part of the body, and could wake up. 

On a side note, I have been surprised by all the news coverage and friends posting about it on Facebook, who have never discussed HIV.  Most never heard about Timothy Brown.  The pessimist in me wondered if the sudden interest was due to a baby being the story, instead of a gay man.  Of course, we all probably worry more about little babies than adults.  But, I couldn't help wondering why so many have never heard of Brown.  The news coverage on him has been scarce, unless you read HIV news. 

http://www.amptoons.com/blog/2005/07/31/we-are-dad-discrimination-against-gay-lesbian-foster-parents/

Offline freaky_dream

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #29 on: March 05, 2013, 07:29:06 pm »
From what was posted on poz.com it turns out the infant is now basically an elite controller rather then actually having been cured of teh "Aids". I still think it is a good step forward as it provides even more proof that we are inching forward to more breakthroughs. I hope this prods Fauci and the NIH to fund additional curative based research.

On the subject of "Aids", news organizations continue to confuse Aids and HIV...

Offline madbrain

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #30 on: March 05, 2013, 07:43:40 pm »
There was a member on these forums about a year ago who started HAART immediately after they had a high risk infection event. They ended up being infected but they couldn't test positive in a normal HIV test because they had medication so early (days?).

There is always a window period for the HIV antibodies to develop after exposure, certainly at least days. So that doesn't seem unusual at all, if that person ended up testing HIV+ later on.

Quote
Does anyone remember this.  To me this sounds similar.

I don't remember seeing it. How is it similar ?
The baby tested positive for HIV. And it also had a viral load.

In the PEP situation, the individual usually tests negative on an antibody test at the time PEP is given.
And no viral load test is being done at that time, certainly not prior to the administration of PEP. Perhaps that is a mistake and they should be.

Also, you said in that other case, ended up being infected, so I fail to see the similarity even further.

« Last Edit: March 05, 2013, 07:59:20 pm by madbrain »

Offline madbrain

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #31 on: March 05, 2013, 07:53:17 pm »
From what was posted on poz.com it turns out the infant is now basically an elite controller rather then actually having been cured of teh "Aids".

Where do you see that ? What article ?

Elite controllers still test positive on HIV antibody tests, so this is not similar.

Offline madbrain

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #32 on: March 05, 2013, 07:56:32 pm »
Yes.  I remember seeing them in a documentary.  I think Rosie O'Donnell got involved.  The HIV poz kids were not deemed adoptable in Florida.  Once the boy no longer tested poz, he was considered adoptable. 

This is a despicable story. But I have to wonder, why would anyone retest him for HIV antibodies after so many years ? This retesting is certainly being done on any of us adult pozzies who live outside of the magical state of Florida.

Offline Newguy

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #33 on: March 06, 2013, 12:11:11 am »


I just watched an interview with the doctor that treated the infant from the University of Mississippi. Despite some people saying this is the same as PEP it clearly is not. The baby was indeed born with HIV. They did a viral load test on her  I believe it was around 20000 copies. Now they immediately put her on anti retrovirals  but Dr. Gay put her on three pills rather than the recommended one pill (we will never know if this would had made a difference). PEP is post exposure prophylaxis putting someone on meds before any replication competent seeding takes place usually within window of 72 hours. 

Eventually the infection supposedly cleared from her system, and it is believed that these long lived memory cells did not seed in the baby because of the nature of how babies develop immune systems. This is indeed a game changer and wildly great news because it almost confirms what immunologists have long believed about the crazy world of immunology. How do some CD4 become memory? and others become effectors? This is the major obstacle to clearing HIV infection from an individual.

Best to all!

In my mind it makes sense to start meds early, the sooner you start the less memory seeding? I have no idea if this rationale will hold but we will find out in the next decade since the guidelines of starting meds early is a relatively new one.


Offline Newguy

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #34 on: March 06, 2013, 12:18:25 am »
Another point I can't get out of my head is that if ARV's are so toxic how does a newborn tolerate them? Especially a triple cocktail and for almost two years?

Best

Offline Newguy

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #35 on: March 06, 2013, 12:20:21 am »
From what was posted on poz.com it turns out the infant is now basically an elite controller rather then actually having been cured of teh "Aids". I still think it is a good step forward as it provides even more proof that we are inching forward to more breakthroughs. I hope this prods Fauci and the NIH to fund additional curative based research.

On the subject of "Aids", news organizations continue to confuse Aids and HIV...

The baby is not an elite controller. This was confirmed by Dr. Persaud.

Offline freaky_dream

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #36 on: March 06, 2013, 05:44:50 am »
The baby is not an elite controller. This was confirmed by Dr. Persaud.

Right, he isn't an elite controller in the classic sense however he has an undetectable viral load which can only be detected by powerful assays. In effect making him an elite controller.

Offline Newguy

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #37 on: March 06, 2013, 07:45:03 am »
Right, he isn't an elite controller in the classic sense however he has an undetectable viral load which can only be detected by powerful assays. In effect making him an elite controller.

If you read what actually happened she is not controlling anything. There is no HIV replication going on in her body. It appears she cleared the infection.

Offline leatherman

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #38 on: March 06, 2013, 01:39:58 pm »
if ARV's are so toxic how does a newborn tolerate them?
because ARVs aren't toxic. They are not poisons. They inhibit/disrupt various stages of HIV replication. While some people (usually <5%) have reported the most unwanted side effects, the word "toxic" doesn't really apply to these medications. ARVs aren't even "toxic" per se to HIV as they do not destroy the virus but disrupt it's life cycle.

Quote
tox·ic adjective \ˈtäk-sik\
Definition of TOXIC

1. containing or being poisonous material especially when capable of causing death or serious debilitation <toxic waste> <a toxic radioactive gas> <an insecticide highly toxic to birds>
2. exhibiting symptoms of infection or toxicosis <the patient became toxic two days later>
3. extremely harsh, malicious, or harmful <toxic sarcasm>
4. relating to or being an asset that has lost so much value that it cannot be sold on the market

always remember: Meds are your friend ;)
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Offline scottieman

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #39 on: March 06, 2013, 03:13:37 pm »
I am baffled behind the science of all of this, but wonder if an adult went on ARV very soon after sero-conversion happened, within say a month and the viral load taken at that time was under 100,000 is this same scenario even somewhat likely for that person?  To me that's a breakthru if it's the case.
August 19, 2011 Negative Oral Swap
August 30-September 4, 2011 (Thought Strep throat really sero-conversion)
October 5th, HIV Diagnosis
October 22 labs, CD4 619, VL 21,000 21%
November 13th, Started Complera
January 9th, Labs CD4 631, VL-UD 28%
March 28th Labs CD4 610, VL-UD 31%
July 2nd CD4 792, 34% VL-75
August 7th, 2012 CD4 899, 35% VL-97
September 17th, 2012 CD4 989, 33% VL-27
November 8, 2012  CD4 850, VL-UD, 39%
December 6, 2012 CD4 849, VL-UD, 39%
April 2, 2013 CD4 904, VL-UD, 33%
July 17, 2013 CD4 988, VL UD, 38.2%

Offline mecch

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #40 on: March 06, 2013, 03:21:25 pm »
Another point I can't get out of my head is that if ARV's are so toxic how does a newborn tolerate them? Especially a triple cocktail and for almost two years?

Best

Leatherman, maybe Newguy meant it this way  -- "if they are supposed to be so toxic, as many still unfortunately believe..."




“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Newguy

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #41 on: March 06, 2013, 04:22:26 pm »
Leatherman, maybe Newguy meant it this way  -- "if they are supposed to be so toxic, as many still unfortunately believe..."

Thanks Mecch

That is exactly what I meant. I for one have been fortunate enough with my ARV's. I really don't mind taking them HOWEVER every time I swallow them I tell my self it won't be for life. Please refrain from replying to this comment that I am dangerously optimistic. I might be I might not be, who cares really it helps me get through the day and it is working fabulously!

Best

Offline Newguy

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #42 on: March 06, 2013, 04:54:56 pm »
I am baffled behind the science of all of this, but wonder if an adult went on ARV very soon after sero-conversion happened, within say a month and the viral load taken at that time was under 100,000 is this same scenario even somewhat likely for that person?  To me that's a breakthru if it's the case.

These people do exist and yes they do not take antiretrovirals anymore. There was a France study on this.

Best

Offline leatherman

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #43 on: March 06, 2013, 05:01:33 pm »
"if they are supposed to be so toxic, as many still unfortunately believe..."
Huh? I was supposed to know that NG meant the opposite of what he wrote?? ::)
"if ARV's are so toxic" does not equal "supposed to be so toxic, as many still unfortunately believe"

Clearly NewGuy has an issue with thinking meds are undesirable as he had implied them to be "toxic", hopes he won't be taking them forever, and implies that it's not optimistic to think one may need to take meds for life.

I really don't mind taking them HOWEVER every time I swallow them I tell my self it won't be for life.
I've been taking HIV meds for 20 yrs. My Grandmother has been taking heart and blood meds for 50. I see no reason to be so upset/pessimistic about the very things that have kept her and I alive and healthy. She's 95 now thanks to her meds, and I'm almost 51 (instead of dying in my late 30s) thanks to the meds. Personally I don't care about taking meds the rest of my life. There's nothing pessimistic about that. The meds I've been on for 10 yrs have given me no grief and have returned me to a level of health that I hadn't known for decades. ;D

Perhaps you should start thinking about your meds from an optimistic view, NewGuy. ;)
leatherman (aka Michael)

We were standing all alone
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Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
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Offline Newguy

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #44 on: March 06, 2013, 05:26:29 pm »
Huh? I was supposed to know that NG meant the opposite of what he wrote?? ::)
"if ARV's are so toxic" does not equal "supposed to be so toxic, as many still unfortunately believe"

Clearly NewGuy has an issue with thinking meds are undesirable as he had implied them to be "toxic", hopes he won't be taking them forever, and implies that it's not optimistic to think one may need to take meds for life.

Let me clarify myself. I don't think the meds are toxic, they tend to have a reputation of being toxic so I was thinking if "they are so toxic and a newborn can tolerate them then they can't really be that toxic"

As for the taking meds for life comment, I like to think that it won't be for life because I am incredibly optimistic that HIV won't be in me forever, and if it is in fact in me forever so be it. I don't necessarily think the meds are undesirable not at all actually, but I would rather not be on them forever. They are incredibly expensive and it does not sit well me that I rely on government to keep me alive.

Best

I've been taking HIV meds for 20 yrs. My Grandmother has been taking heart and blood meds for 50. I see no reason to be so upset/pessimistic about the very things that have kept her and I alive and healthy. She's 95 now thanks to her meds, and I'm almost 51 (instead of dying in my late 30s) thanks to the meds. Personally I don't care about taking meds the rest of my life. There's nothing pessimistic about that. The meds I've been on for 10 yrs have given me no grief and have returned me to a level of health that I hadn't known for decades. ;D

Perhaps you should start thinking about your meds from an optimistic view, NewGuy. ;)

Offline Souledout

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #45 on: March 06, 2013, 06:53:41 pm »
These people do exist and yes they do not take antiretrovirals anymore. There was a France study on this.

Best

These people seem to develop characteristics similar to elite controllers. They still test positive to antibody tests and have a small amount of virus in their bodies. I think it took an average of 7 years for their viral load to begin to rise (that after 3 years on HAART). So they've not been cured like this baby but have got a functional cure for a limited period of time.
Infection sometime April-August, no noticable seroconversion symptoms
Not currently on medication
13/09/12 CD4 672 (33%) VL <40 (diagnosis date)
18/09/12 CD4 ?               VL 43
27/09/12 CD4 ?               VL 127
19/11/12 CD4 676 (38%) VL 959
03/03/13 CD4 642 (32%) VL 291
04/07/13 CD4 791 (33%) VL 26,437 (active cold sore, tooth infection)
18/07/13 ------retest------VL 3704
18/11/13 CD4 802 (36%) VL 65

Offline mecch

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #46 on: March 06, 2013, 08:08:40 pm »
What can I say, comes with the job teaching communication, you get some intuition about the meanings behind the word choices, on paper.  :o
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Offline madbrain

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #47 on: March 06, 2013, 08:24:59 pm »
I am baffled behind the science of all of this, but wonder if an adult went on ARV very soon after sero-conversion happened, within say a month and the viral load taken at that time was under 100,000 is this same scenario even somewhat likely for that person?  To me that's a breakthru if it's the case.

Yes, it would be.

But of course, many people have no idea when their seroconversion is happening due to lack of symptoms, or very non-specific symptoms.

People who are aware they had a risk of exposure, and aware of the existence of PEP, can already request it. PEP is a 1-drug regimen. I have read about PEP reducing risk of infection by 80%. Maybe a 3-drug regimen would have better odds. But you still have to be aware of your exposure in order to get it. That is the biggest obstacle to the usefulness of PEP and perhaps this new combination PEP.

Offline madbrain

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #48 on: March 06, 2013, 08:29:11 pm »
These people seem to develop characteristics similar to elite controllers. They still test positive to antibody tests and have a small amount of virus in their bodies. I think it took an average of 7 years for their viral load to begin to rise (that after 3 years on HAART). So they've not been cured like this baby but have got a functional cure for a limited period of time.

Do you have any pointers to data/studies on this ?

My understand is that elite controllers just control the virus because of genetic makeup, and it does not rise, not after 7 years, or at any point.
So that would be quite different than what you describe.

"A functional cure for a limited period of time" is not a cure, IMO.

Offline Dr.Strangelove

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #49 on: March 06, 2013, 10:35:07 pm »
This is the French study that showed that some adults that started meds right away during or shortly after seroconversion have been able to stop taking meds later on and remain either undetectable or with a low viral load.
(I certainly would not call this a functional cure)

As pointed out before, this is not the same as what happened to the baby.


Btw While I think this lucky baby will not help finding a cure for those that are already positive, I share Newguys's optimism and don't expect having to take meds until the rest of my life. But if I'm wrong, that's fine too. What's important is that they work and have little side effects. ... And it would be nice if they were priced, so that everyone who needs them can afford them

 


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