HIV/AIDS

WHO welcomes news that a child born with HIV now appears “functionally cured” through early antiretroviral treatment

GENEVA, 5 March 2013 — WHO welcomes a new case report, which found an HIV-infected infant treated with triple antiretroviral drugs (ARVs) in the first 30 hours of life appeared to be functionally cured after taking treatment for 18 months, but notes the need for more studies to confirm and replicate the findings.

These findings were presented yesterday at the 20th Conference on Retroviruses and Opportunistic Infections (CROI) held in Atlanta, USA (abstract Persaud et al).

The report states that the mother, who was living with HIV when the baby was born, had not received ARVs or prenatal care. Researchers report that because of the high risk of HIV transmission, the baby was put on a triple therapy regimen of ARVs at 30 hours of life. Blood test results showed that on two separate specimens, the infant was found to have detectable virus prior to starting antiretroviral treatment.

According to the report, a series of viral tests during treatment showed a progressive reduction of virus in the infant’s blood, until it reached undetectable levels at 29 days after birth. The infant remained on ARVs until 18 months of age, at which point the child was lost to follow-up and, the researchers say, stopped the treatment. Ten months after the interruption of treatment, the child underwent repeated standard blood tests, none of which detected virus in the blood or HIV-specific antibodies.

If the findings are confirmed this would be the first well-documented case of an HIV-infected child who appears to have no detectable levels of the virus after having taken and stopped HIV treatment for a substantial period. This case highlights a possible new approach for high risk infants whose mothers have not received any treatment prior to birth.

At the end of 2011, there were an estimated 330 000 children newly infected with HIV, a 24% reduction in new infections from 2009. WHO, UNICEF and UNAIDS are committed to elimination of paediatric HIV by 2015 as outlined by the Global Plan. According to the latest global estimates from 2010, 28% of infants born to HIV-infected mothers are tested for HIV within six weeks of birth. But, in many low- and middle-income countries, even if early infant diagnosis testing with polymerase chain reaction (PCR) is done between 4-6 weeks as recommended by WHO, the turn-around time to receive the results and act upon those can be several weeks, due health systems constraints.

WHO is enthusiastic about this interesting case report and looks forward to the confirmation of these results through future studies. Meanwhile, WHO will maintain the current recommendations of early HIV testing of pregnant women and provision of ARVs to all HIV positive mothers, along with infant prophylaxis, to prevent mother-to-child HIV transmission (PMTCT). The implications of this case study are not very clear at this point until more information becomes available. However it does point to the potential need for earlier access to HIV diagnostics to infants born to HIV positive mothers. WHO is in the process of reviewing its guidance on early infant diagnosis (EID) in 2013 and all new data will be reviewed as they become available. WHO will be releasing updated, consolidated guidelines on ARVs, including for pregnant women and exposed infants, in mid-2013.

For more information, contact:

Mr Tarik Jasarevic
WHO Communications Officer
Telephone: +41 22 791 5099
Mobile: +41 79 367 6214
E-mail: jasarevict@who.int

Ms Tunga Namjilsuren
WHO Communications Officer
Mobile: +41 79 203 3176
E-mail: namjilsurent@who.int

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