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Author Topic: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs  (Read 7874 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
"He is my oldest child. The shy and retiring one over there with the Haitian headdress serving pescaíto frito."

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!
08/2010 HIV- 08/2012 HIV+
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04/2013 CD4 457(15%)
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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
2011 May - Neg.
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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 »
08/2010 HIV- 08/2012 HIV+
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04/2013 CD4 457(15%)
10/2013 CD4 520 (20%) VL 650 (wtf?)
02/2014 CD4 410(20%) VL 390 (yay!)

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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"...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 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+
10/2012 CD4 415(15%)
04/2013 CD4 457(15%)
10/2013 CD4 520 (20%) VL 650 (wtf?)
02/2014 CD4 410(20%) VL 390 (yay!)

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 »
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"...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/
tivicay/kivexa

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.
In a far better p[lace than this minging shithole

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
In a far better p[lace than this minging shithole

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.
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 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.
11/02/2010  cd4-251, vl-591000
12/09/2010  started Atripla
02/18/2011  cd4-425, vl-800
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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.


Online 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 .

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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chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

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..."




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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 mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

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

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

Offline tednlou2

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #50 on: March 07, 2013, 02:25:43 AM »
I have always wondered what effect, if any, the Sustiva I was put on had on my virus.  As everyone and their brother knows by now, I was given Sustiva mono-therapy in the hospital.  I had a CD4 of 171.  The short course that was started and stopped did get me UD and a CD4 over 1,000.  I developed resistance to most NNRTI'S with the K103 mutation, or whatever it's called. 

Since that time in 2008, my labs have been high 600's to high 700's, with an average vl of around 15k.  I did ask a HIV doc, whether that mistake at the cost of resistance could have weakened my virus.  I think he said theoretically, but probably not.  The thinking was my CD4 was artificially low due to being so ill, and it just returned to where it was.  And, that's probably the case.  I am not as knowledgable on these things as so many are.  However, it did make me wonder whether I was really at the AIDS level and that's why I got so ill.  I am sure I am wrong.  I mean, I just wonder.  It isn't something I believe to be the truth. 

Offline Souledout

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #51 on: March 07, 2013, 04:47:59 AM »
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.

Develop characteristics not a changed genetic make up - meaning their ability to control the virus without HAART . If you define functional cure as a lack of viral replication with the absence of anti retroviral drugs, then they are functionally cured BUT for a limited period of time. I didn't say they were cured, or even functionally cured. And even elite controllers sometimes lose their ability to control the virus over time, losing the status when they do.
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 Ann

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #52 on: March 07, 2013, 08:20:34 AM »

PEP is a 1-drug regimen.


PEP is NOT a 1-drug regimen. It's a two or more usual, a three drug regimen.

Sometimes people are only give Truvada, which is two drugs.

More usual, people are given Truvada plus Kaletra. I've been seeing people in the Am I forum lately (most of whom do  NOT need PEP in the first place) being put on Atripla, but this is not a standard PEP combo because of the Sustiva side-effects.

Madbrain, I don't know where you ever got the idea that PEP was only one drug. It's never been one drug. Not even PrEP is one drug - it's Truvada which is two. (Truvada is the only combo approved for PrEP.)

The only PEP-like monotherapy that I know of is when they give babies liquid AZT for the first six weeks of life - and that's usually when the mother has been on meds during the pregnancy and has a controlled viral load.

THIS particular baby was given a three-med combo, probably because her mother hadn't been on meds during pregnancy.
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Offline scottieman

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #53 on: March 07, 2013, 03:48:40 PM »
Thanks for all of the helpful information.  I sero-converted and went on meds at about the 6 week mark, my VL was at less thank 20K copies, and I went to UD almost immediately.  Over the course of the next year, I had a couple months where my VL rose to numbers still under 100 but detectable by today's standards.  I've been on ARV's now since November of 2011, and will continue to take, but hold out some "hope" now that maybe my choice to start meds immediately to preserve my immune system and stop any latent reservoirs was the right choice.  Maybe someday I can safely stop talking medication!  Until then, I am grateful for the medication I can get, and how well it works.
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 Matts

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #54 on: March 07, 2013, 03:55:50 PM »
I am not a doctor or scientist, but I think 6 weeks of infection are more than enough to establish a huge reservoir of latent cells. Maybe after immediate treatment (some days) after infection you have a chance to overcome HIV after some months of drug treatment. :(
But You can try interruption, maybe You have a lot of luck. It happened here in Berlin for some patients,  why not for You.
« Last Edit: March 07, 2013, 03:57:53 PM by Matts »
tivicay/kivexa

Offline anniebc

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #55 on: March 07, 2013, 04:40:19 PM »
I am not a doctor or scientist, but I think 6 weeks of infection are more than enough to establish a huge reservoir of latent cells. Maybe after immediate treatment (some days) after infection you have a chance to overcome HIV after some months of drug treatment. :(
But You can try interruption, maybe You have a lot of luck. It happened here in Berlin for some patients,  why not for You.

Hi Matts

I'm not quite sue if I'm picking you up right, but are you suggesting to Scottieman that he can take a drug holiday?

Jan
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Offline John2038

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #56 on: March 07, 2013, 05:26:35 PM »
FYI

Limiting the size of the reservoir by early treatment (CROI)

Source

..

Patients treated early in acute infection, whether in stages Feibig 1 or 3, showed similar characteristics to 'elite' HIV controllers – a small or undetectable reservoir of HIV DNA, and a bias towards infection of transitional and effector cells rather than central memory cells, concluded Dr Ananworanich. These patients may be ideal candidates for future cure studies which look at the use of therapeutic vaccines in combination with agents that can deplete the HIV reservoir. In due course, treatment interruptions might also be attempted in order to determine whether any of these patients is functionally cured, and if so, what might be the immunologic correlates of a functional cure.

Dr Katherine Luzuriaga also presented data on the characteristics of the HIV reservoir after early treatment, this time in five adolescents with a median age of 16 who had received antiretroviral treatment since soon after birth (median 2 months of age). It was impossible to isolate replication-competent HIV DNA from any of these patients, although proviral DNA was detectable at a low level, and they had no HIV-specific antibody or CD8+ T-cell responses. In comparison, four age-matched young people who had begun HIV treatment in later childhood, and who had sustained undetectable viral load ever since, had detectable HIV RNA (8 copies/ml) by ultrasensitive assay and HIV antibody and CD8+ T-cell responses to a broad range of HIV genes, indicating ongoing replication.

Dr Luzuriaga’s group suggested that these young people, like the acutely infected Thai patients described by Dr Ananworanich, could be “prime candidates for interventions to achieve functional cure or eradication.”

In contrast, data presented by collaborators from the University of Pittsburgh and Harvard University, show that in adults treated with fully suppressive antiretroviral therapy for at least ten years, but commenced in advanced HIV disease (median CD4 cell count 193 cells/mm3), HIV DNA declines during treatment, but remains detectable after ten years, with higher levels correlated with older age and higher baseline viral load. These findings suggest a much more well-established reservoir of HIV infection in chronically infected adults.

Offline Matts

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #57 on: March 07, 2013, 07:57:07 PM »
Annie

My posting was too sloppy. I would never recommend a drug holiday.
There are some cases like the "Berlin Patient Number1" who could stay off ART after a treatment break.

The theory is, that immediate treatment after infection prevents the latent reservoirs and the virus can be cleared with ART. I think that's how PEP works. In our city the PEP is used nearly 600 times a year in three different hospitals, and as far as I read it always worked, when it was used within 72 hours.
 But more research is needed for this topic.
« Last Edit: March 07, 2013, 08:05:24 PM by Matts »
tivicay/kivexa

Offline madbrain

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #58 on: March 07, 2013, 09:24:47 PM »
PEP is NOT a 1-drug regimen. It's a two or more usual, a three drug regimen.

Sometimes people are only give Truvada, which is two drugs.


Sorry, my mistake. The one time that somebody I know had to use it, which was many years ago, it was not three drugs. I could have been two. I don't remember which one it was.

Offline madbrain

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #59 on: March 07, 2013, 09:32:08 PM »
Develop characteristics not a changed genetic make up - meaning their ability to control the virus without HAART . If you define functional cure as a lack of viral replication with the absence of anti retroviral drugs, then they are functionally cured BUT for a limited period of time. I didn't say they were cured, or even functionally cured. And even elite controllers sometimes lose their ability to control the virus over time, losing the status when they do.

My point is that "Cured" and "for a limited period of time" are two antithetical terms.  You just can't use those terms together. You are simply using the wrong word.

Offline leatherman

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #60 on: March 07, 2013, 09:37:00 PM »
There are some cases like the "Berlin Patient Number1" who could stay off ART after a treatment break.
The Berlin Patient Timothy Brown had a lot more happen than a treatment break. ::)

Besides, after you've been radiated and chemo-ed nearly to death then had your immune system totally replaced, basically eradicating the HIV in your system (not really "curing" you as a layman would think), would it really be called a treatment break to not be on meds anymore when there was no HIV in your new system? ???
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Souledout

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #61 on: March 07, 2013, 10:41:18 PM »
My point is that "Cured" and "for a limited period of time" are two antithetical terms.  You just can't use those terms together. You are simply using the wrong word.

Semantics. You know what I'm getting at, functional remission doesn't have the same ring to it.
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 Souledout

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #62 on: March 07, 2013, 10:46:37 PM »
Thanks for all of the helpful information.  I sero-converted and went on meds at about the 6 week mark, my VL was at less thank 20K copies, and I went to UD almost immediately.  Over the course of the next year, I had a couple months where my VL rose to numbers still under 100 but detectable by today's standards.  I've been on ARV's now since November of 2011, and will continue to take, but hold out some "hope" now that maybe my choice to start meds immediately to preserve my immune system and stop any latent reservoirs was the right choice.  Maybe someday I can safely stop talking medication!  Until then, I am grateful for the medication I can get, and how well it works.

If your seroconversion illness was at the very end of August and you started treatment mid November that's over 10 weeks isn't it? Which is still very soon by all accounts.
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 Matts

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #63 on: March 07, 2013, 11:41:03 PM »
The name "berlin patient" was confusing, I have to admit.
I meant the first one from 1996, Timothy Ray brown is here labelled as Number 2.:)

"In the history of AIDS, two men—both dubbed “the Berlin Patient”—will be remembered as harbingers in the quest for a cure.
The first Berlin Patient was a young German man who in 1996 sought care due to flu-like symptoms about three weeks after having unprotected sex. His doctor, Heiko Jessen, started him on ART and hydroxyurea, a cancer drug.
Hydroxyurea expert Franco Lori described the case at an AIDS conference in Hamburg in 1997. After starting combination therapy, the man rapidly reached an “undetectable” viral load according to an older test with a lower limit of 500 copies/mL. When he stopped his drugs a few months later due to a bout of hepatitis A, his HIV viral load stayed undetectable. About five
weeks later, he decided to permanently discontinue therapy and his virus remained suppressed.
This Berlin Patient was the first individual known to have achieved “remission” of HIV, and the case made headlines around the world, including a profile in the New York Times Magazine. Lori’s team presented further details at CROI 1999 and in the May
27, 1999, New England Journal of Medicine. By that time, Berlin Patient #1 had been off treatment for about two years, still with
no plasma viral rebound. But traces of HIV RNA were detected in his lymph nodes, and replication-competent virus was isolated from a small number of resting CD4 T-cells after Robert Siliciano developed a sensitive test.
Although his HIV was not eradicated, the man’s immune system managed to control the virus, demonstrating that a functional cure is within the realm of possibility. “I’ve never met him, and I don’t even know his name, but I’ve followed his case,” a member of an HIV positive support group told journalist Mark Schoofs. “He is what we want to be.
The second Berlin Patient came to the world’s attention a decade later. An American man living in Germany, he underwent
treatment for acute myeloid leukemia at Berlin’s Charité Medical University in 2006........" (Page 20)
(The rest is known).


I think the source is a good read about HIV latency:

http://www.sfaf.org/hiv-info/hot-topics/beta/2011-beta-winterspring-eradication.pdf

tivicay/kivexa

Offline Souledout

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #64 on: March 08, 2013, 05:39:20 AM »
So, the long and short of it is that I'm moving to Berlin.
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 #65 on: March 08, 2013, 07:51:36 AM »
Hey thanks. I never heard of that first Berlin Patient...

________________

Throwing this out there.....   Maybe everyone identified in seroconversion should be advised to start treatment...  Maybe we are missing some opportunities here to create at least some LTNPs or functional cures in adults...  All the results that are not spectacular, will still result in HIV+ people who only had a month or two of detectable viral load in their lives....  But a guess a wrench in this pipe dream is that the infection might be with a strain that requires a certain combo, so quick identification of that would be required, as well...
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline leatherman

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #66 on: March 08, 2013, 09:13:40 AM »
Hey thanks. I never heard of that first Berlin Patient...
all these yrs and I never heard of this patient #1 either; but here are some more links
http://www.nytimes.com/1998/06/21/magazine/the-berlin-patient.html?pagewanted=all&src=pm
http://www.investorvillage.com/smbd.asp?mb=1933&mn=48657&pt=msg&mid=12415426
http://ksj.mit.edu/tracker/2011/02/updated-and-amended-bloomberg-berlin-pat

what I'm wondering, but not seeing, is what happened with patient #1? The original story is from 1998; but I didn't find any follow up to this story. Which seems very weird. What I did find was that Mark Schoof's was the first to report on BOTH berlin patients (http://www.nytpick.com/2008/11/times-takes-on-wsjs-aids-scoop-and.html). which seems weird too.

does anyone have any more info about patient#1??
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Tadeys

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #67 on: March 08, 2013, 09:27:33 AM »
His doctor, Heiko Jessen, started him on ART and hydroxyurea, a cancer drug.


Hydroxyurea...hummmmmmmm.

Offline idee

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #68 on: March 09, 2013, 12:32:37 AM »
To me it is a game changer. To get to number 40 million you must pass number 2 first.

Best

I like that saying.

Offline idee

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #69 on: March 09, 2013, 12:38:45 AM »
My mom told me about this and she watches the news on hiv closer than I do. I hope these cures lead to a cure for the rest of us.

Offline idee

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #70 on: March 09, 2013, 12:43:10 AM »
all these yrs and I never heard of this patient #1 either; but here are some more links
http://www.nytimes.com/1998/06/21/magazine/the-berlin-patient.html?pagewanted=all&src=pm
http://www.investorvillage.com/smbd.asp?mb=1933&mn=48657&pt=msg&mid=12415426
http://ksj.mit.edu/tracker/2011/02/updated-and-amended-bloomberg-berlin-pat

what I'm wondering, but not seeing, is what happened with patient #1? The original story is from 1998; but I didn't find any follow up to this story. Which seems very weird. What I did find was that Mark Schoof's was the first to report on BOTH berlin patients (http://www.nytpick.com/2008/11/times-takes-on-wsjs-aids-scoop-and.html). which seems weird too.

does anyone have any more info about patient#1??

Are you talking about Timothy Ray Brown? He is the one guy who was cured of HIV and cancer with a bone marrow transplant in Berlin.  http://www.youtube.com/watch?v=6Uf0ypNHz0E

Offline Miss Philicia

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #71 on: March 09, 2013, 01:34:27 AM »

Hydroxyurea...hummmmmmmm.

hmmm what? I took that vile drug myself back in the early 90's when there were only two HIV meds available. Possible bone marrow toxicity, anemia, stomatitis, etc.  the list goes on as far as possibilities.
"I’ve slept with enough men to know that I’m not gay"

Offline leatherman

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #72 on: March 09, 2013, 01:52:41 AM »
Are you talking about Timothy Ray Brown? He is the one guy who was cured of HIV and cancer with a bone marrow transplant in Berlin.  http://www.youtube.com/watch?v=6Uf0ypNHz0E
nope. this is a whole different guy. A "berlin patient" in 1998. He was supposedly treated earlier in his infection, the hiv seemed to go into remission..... and then I can't find anything else about him. which really doesn't bode well. You'd think if he had been "cured", even as a functional cure, there would be more follow-up all these yrs later. It seems like you've been just as in the dark as I have been about this guy, this "berlin patient #1"

it turns outs our that Tim Brown is actually "berlin patient #2" - but with a completely different situation.

here's the story, as told in that second link I posted:
Quote
Two Berlin Patients
This Berlin Patient was the first individual known to have achieved “remission” of HIV, and the case made headlines around the world, including a profile in the New York Times Magazine. Lori’s team presented further details at CROI 1999 and in the May 27, 1999, New England Journal of Medicine. By that time, Berlin Patient #1 had been off treatment for about two years, still with no plasma viral rebound. But traces of HIV RNA were detected in his lymph nodes, and replication-competent virus was isolated from a small number of resting CD4 T-cells after Robert Siliciano developed a sensitive test.

Although his HIV was not eradicated, the man’s immune system managed to control the virus, demonstrating that a functional cure is within the realm of possibility. “I’ve never met him, and I don’t even know his name, but I’ve followed his case,” a member of an HIV positive support group told journalist Mark Schoofs. “He is what we want to be.”

The second Berlin Patient came to the world’s attention a decade later. [this is Mr. Brown, Idee ;) ]An American man living in Germany, he underwent treatment for acute myeloid leukemia at Berlin’s Charité Medical University in 2006. At that time, he had been HIV positive for more than ten years and on ART for four years, and had undetectable viral load. But he had a history of high viral load and disease progression, so was not a natural elite controller.
http://www.investorvillage.com/smbd.asp?mb=1933&mn=48657&pt=msg&mid=12415426

started him on ART and hydroxyurea, a cancer drug.
Hydroxyurea...hummmmmmmm.
hmmmm, AZT was a cancer drug too. ;) ::)
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Larsen

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #73 on: March 09, 2013, 10:41:35 AM »
The thing to remember about 1996, which is when this thing with the German guy is supposed to have happened, was that triple drug therapy was the new buzz and Time magazine was naming David Ho their 'Man of the Year' for declaring that it could totally eradicate HIV from the body within 18 to 36 months of therapy commencing. It was the optimistic high that popped and made the 'cure' pretty much taboo for another decade.

I am guessing that this patient #1 just turned out to be another of the however many thousand long-term nonprogressors (remembering here that the CCR5-Δ32 mutation is by far and away at its most common amongst ethnic Germans and Nordics).
« Last Edit: March 09, 2013, 10:47:24 AM by Larsen »
In a far better p[lace than this minging shithole

Offline vaboi

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Re: HIV-Infected Infant Cured With Early Use of Virus-Blocking Drugs
« Reply #74 on: March 10, 2013, 06:23:50 AM »
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.

I'm one of these people.  I started ARV three weeks after likely infection.  However my VL was much higher than 100k since I was in seroconversion at the time.  When I went to the doc office, I was so sure the "flu-like" symptoms were from HIV that I insisted they give me a VL test over the antibody test, which they finally agreed to once they ruled out mono or any other cause.  If I only knew what I knew today, I would have insisted on beginning meds at that moment and I could have started 1 week after the event.   But it's now been 3 years for me and I'm not about to stop ARV just to "test" whether VL stays low for awhile.  I'd rather take them for 10 more years and maybe by then I will really be cured.   Who knows...

 


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