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HIV-Infected Infant Cured With Early Use of AIDS Drugs
- tokenadult 14y agoThe treatment details from this interesting article and from the Guardian article http://www.guardian.co.uk/society/2013/mar/03/us-doctors-cure-child-born-hiv http://www.guardian.co.uk/society/2013/mar/03/us-doctors-cur... and New York Times article http://www.nytimes.com/2013/03/04/health/for-first-time-baby-cured-of-hiv-doctors-say.html http://www.nytimes.com/2013/03/04/health/for-first-time-baby... just submitted to HN http://news.ycombinator.com/item?id=5315660 http://news.ycombinator.com/item?id=5315660 http://news.ycombinator.com/item?id=5315673 http://news.ycombinator.com/item?id=5315673 make clear that this is a very unusual case. The baby's HIV infection was acquired from an infected mother, but her HIV status was not known until she was in labor. Because she did not receive the usual preventive treatment given to HIV-positive pregnant women, the baby received three-drug therapy rather than one-drug therapy as the baby's treatment began after birth. The baby's current status of no detectable infection after a hiatus in drug therapy is a very unusual outcome. It's unclear how likely it is that this result could be reproduced in other patients. Thousands of failures to attain the same outcome have already happened all around the world. From the Bloomberg article submitted to open this thread: "The baby, whose identity has been kept anonymous, began taking a regimen of AIDS drugs about 30 hours after she was born at a rural Mississippi hospital, doctors said today at a medical meeting in Atlanta. 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. . . . . "The baby’s treatment combined lamivudine and zidovudine, both sold by GlaxoSmithKline Plc’s joint venture with Pfizer Inc., ViiV Healthcare, and Abbott Laboratories’ Kaletra." From the New York Times article: "If the report is confirmed, the child born in Mississippi would be only the second well-documented case of a cure in the world, giving a boost to research aimed at a cure, something that only a few years ago was thought to be virtually impossible. "The first person cured was Timothy Brown, known as the 'Berlin patient,' a middle-aged man with leukemia who received a bone-marrow transplant from a donor genetically resistant to H.I.V. infection." From the Guardian article: "Children infected with HIV are given antiretroviral drugs with the intent to treat them for life, and Gay warned that anyone who takes the drugs must remain on them. "'It is far too early for anyone to try stopping effective therapy just to see if the virus comes back,, she said." AFTER EDIT: Following up on some of the other top-level comments here, gojomo asks how the case reported in this thread differs from Magic Johnson's condition. Magic Johnson has consistently taken his antiretroviral drugs, which were first developed only shortly before his HIV infection was diagnosed, throughout the decades since he was diagnosed. He has never had a hiatus in treatment. What's remarkable about the case reported today is that the baby's treatment was stopped at about age eighteen months, but the child still has no detectable HIV infection. I remember all too well when AIDS was a sure death sentence. The development of effective antiretroviral drugs in the early 1990s was a huge surprise. Even today, there are very few drugs that are effective against any kind of viral infection (although there are many vaccines that kind prevent viral infections, and smallpox has been completely eliminated from humankind). Another comment asked about cures for diseases announced in recent years. For the most part, reductions in disease risk are gradual, mostly from accumulation of better practice in treatment and prevention. But the death rate from all causes of death at all ages is steadily declining in the developed world, http://www.scientificamerican.com/article.cfm?id=longevity-why-we-die-global-life-expectancy http://www.scientificamerican.com/article.cfm?id=longevity-w... and has been throughout my lifetime. For more than a century, humankind has been gaining life expectancy at the steady rate of fourth months per year (or one extra day of life for each day you live), http://www.prb.org/Journalists/Webcasts/2010/humanlongevity.aspx http://www.prb.org/Journalists/Webcasts/2010/humanlongevity.... http://www.demographic-challenge.com/files/downloads/2eb51e2860ef54d218ce5ce19abe6a59/dc_biodemography_of_human_ageing_nature_2010_vaupel.pdf http://www.demographic-challenge.com/files/downloads/2eb51e2... http://www.pnas.org/content/105/36/13274.full http://www.pnas.org/content/105/36/13274.full so a girl born in the last decade in the developed world has a better than even chance to living to age 100.
- napoleond 14y ago"I remember all too well when AIDS was a sure death sentence." There was an excellent documentary released last year about the HIV/AIDS epidemic of the 80s and 90s, which I can't recommend highly enough. It's deeply interesting and eye-opening on several levels: http://surviveaplague.com/ http://surviveaplague.com/
- machbio 14y agoI do have the same opinion, It seems that like a miracle to me - it is not backed by hard evidence.. for any scientist it will feel like just another case of "Black swan"..wrote about.. http://www.machb.io/2013/its-hyped-up/ http://www.machb.io/2013/its-hyped-up/ Being a Biologist, the viral infections and its treatments are as vague and treatments are not reproducible..
- hakaaaaak 14y ago"With no signs of the virus for 10 months..." Does this mean that the virus could still be incubating in cells and some sort of stressor could cause the virus to come out, similar to those that have had Chicken Pox getting Shingles later in life? If so, is it really a cure? To me, a vaccine that has passed all trial stages and works almost 100% and w/few side effects is a cure. I don't want to belittle this miracle, but complacency caused by misleading news is much, much worse than playing it down and getting it right before announcing there is a cure. Hope is a wonderful thing though.
- TillE 14y agoA vaccine is not a cure. It's prevention - which already exists for mother to child HIV transmission. Anyway, the doctors don't make any absolutely definitive statements, but: "Now, after at least one year of taking no medicine, this child's blood remains free of virus even on the most sensitive tests available" http://www.guardian.co.uk/society/2013/mar/03/us-doctors-cure-child-born-hiv http://www.guardian.co.uk/society/2013/mar/03/us-doctors-cur...
- hakaaaaak 14y ago> A vaccine is not a cure. It's prevention True. My point was that the title of the post indicated that the child was cured. We don't know that yet, and may not know for some time. It will be nearly impossible to eradicate HIV without prevention. If this child has unprotected sex as an adult thinking that it is cured, is that safe? We don't know. Maybe the virus will show again in their adulthood. However, if a vaccine is found and we can prove the vaccination works, that provides a lot more security. Because of many of our parents getting vaccinated, Smallpox got to the point where their children (us) didn't have to get vaccinated. That is where we need to get with HIV. Because of AZT, etc. people just assume it is more of an annoyance now, like Herpes that can be managed. We need adequate resources dedicated and I am concerned that touting a cure that may not be is not in the public's best interest.
- kingkawn 14y agoVaricella Zoster Virus is a true latent infection. HIV is constitutively active and never truly latent in the sense that it goes into dormancy. The virus is constantly replicating and being released, the only thing that causes it to assume what looks like latency is taking drugs on a daily basis. those drugs do not address the virus that is within cells, only preventing that virus from spreading and causing AIDS.
- emiliobumachar 14y agoFor those of you too young to remember the 90's, AIDS meant sure death in very few years. It was worse than cancer: with some cancers, you stood a chance. How far we've come :)
- InclinedPlane 14y agoIn more ways than one. It's taken decades if not centuries of study of other diseases to understand them and to develop treatments, and just as much time for treatments to have an impact on incidents of the disease. The study of HIV/AIDS has really shown off how far modern medicine and medical research has come. We were able to understand the disease in a matter of years, and develop some crude but effective treatments almost as quickly. Today HIV has become a treatable chronic condition, though the treatments are costly, and vaccines and cures are being developed as we speak. It's really quite remarkable.
- zera_holladay 14y agoIt is remarkable. See http://en.wikipedia.org/wiki/Ryan_White http://en.wikipedia.org/wiki/Ryan_White. There were competing social forces too.
- ekianjo 14y agoMy understanding is HIV is still more or less a death sentence, with the antiretroviral therapies being relatively effective to push back the final outcome. And there are issues not being discussed here, such as compliance issues with the treatments (adverse reactions and so on) that make patients drop the treatments. It's far from being perfect yet.
- carbocation 14y agoIt's more of a chronic disease than a death sentence. We all die, and if you push back the final outcome far enough, your odds of dying from something else outgun your odds of dying from HIV/AIDS. For example, those with HAART-treated HIV infection who have been treated for four years or more tend to die from a non-AIDS-related cause rather than from an AIDS-related one. [1] [1] = https://www.ncbi.nlm.nih.gov/pubmed/20380565 https://www.ncbi.nlm.nih.gov/pubmed/20380565
- gojomo 14y agoI wonder how this child's "blood remains free of the virus" status compares to the 'undetectable' viral loads reported for others (eg Magic Johnson) for many years. Is there a qualitative difference?
- kintamanimatt 14y agoSuch people who are undetectable are also on meds. People who are not on meds don't have undetectable viral loads. I wonder if the kid has the CCR5-Δ32 mutation, which seems to provide natural immunity against certain strains of HIV.
- GeorgeJetson 14y agoThe HIV-AIDS hypothesis is a hoax concocted by someone who never did any research on HIV. Do your research please.
- signed0 14y agoBeing fairly young, I can not remember a time in my life when a disease was cured or a vaccine created that significantly reduced transmission. I keep expecting a grand announcement like "AIDS cured" or "Cancer defeated" but there are always so many caveats that it feels like progress isn't being made. I wonder if it was the same way with other diseases in the past, and I am just being important, or if modern day ones are somehow different.
- chimeracoder 14y agoHIV and cancer are particularly tricky. HIV mutates incredibly quickly, which makes it incredibly hard to find a "vaccine", because something that works against one strain probably won't work against the others. The same goes for treatments - most HIV patients have to take a various combinations of drugs (the slang term is their "cocktail") which vary in effectiveness both per-patient and over time. Cancer is difficult for a different reason altogether: it's the body's own cells. To oversimplify, it's (relatively) easy to find a medicine that can target foreign cells, but it's hard to find a medicine that will target cancerous cells and not be equally deadly (or more deadly) to healthy cells, because cancerous cells so closely resemble healthy ones. Progress is being made - just look at Bill Gates and his campaign for eradicating polio.
- gus_massa 14y agoAnother problem with cancer is that is not a single illness, but a family of diseases covered with a single name. Bone cancer is very different of pancreatic cancer that is very different from lung cancer that is very different from colon cancer that is very different from ... Some cure approaches work with all of them, but other approaches are more specific. Trying to eradicate all forms of cancers is like trying to eradicate all bacterial diseases at once.
- ekianjo 14y agoYes and No. You/We should not classify the cancers by "locations". It makes as much sense as classifying a leak in the house as "bathroom leak", "ceiling leak", "stairs leak". There are different cancers happening in different locations of the body and some share the same roots no matter where they start. The fact that they affect a specific organ is not necessarily related to the cancer type itself. There are often several mutations even for a single "cancer location" identified.
- anon4chan 14y agohow is this hacker news moroon
- gnnr 14y agoWell you have to consider a lot of innovation with technology and medical research led to this point. This article speaks only of the result of the work, but surely if you dig deeper you would find there are many smart people working on this issue, and I'd gladly lump them into the category of hackers.
- carbocation 14y agoOne has to wonder if the infant is homozygous for the noted CCR5 variant that confers resistance to HIV infection. This could potentially explain a high viral load with negative titers later. I can't tell (from the relatively scant details) if the child ever developed HIV infection, by which I specifically mean to include infiltration of a cell by the virus, replication, and a host reaction. I can't find text in the articles describing which blood tests were done on the child. If her ELISA and Western blot are negative (still) but she initially had a nucleic acid amplification test that was positive with high titer, then it would make me wonder if the drugs, for this baby, were not necessarily the key element causing her to be disease free. I.e., I would wonder if the infant weren't actually cured because she was never fully infected in the first place. If she was truly infected and her body was reacting to the replicated pathogen, then this early treatment strategy is extremely interesting.
- HarryHirsch 14y agoAlso see: the Milwaukee protocol for rabies. No one knows just why it works for some people but not for others, but early treatment is key.
- OGinparadise 14y agoThose researchers also were unable to find any trace of the virus, prompting them to determine the baby had essentially been cured. I am hoping for the best, it would a gift of life for millions, and drug cos can't hold this even if it cost them billions to make. Horrible PR and all. However, could the virus still be there but under the test's threshold?
- iframe 14y agoI highly recommend this documentaries , House of numbers http://www.youtube.com/watch?v=fELMm5mAeXU http://www.youtube.com/watch?v=fELMm5mAeXU and The Greatest Medical Fraud in History http://www.youtube.com/watch?v=vT3b_0doyRk http://www.youtube.com/watch?v=vT3b_0doyRk
- xutopia 14y agoDude... where is the evidence? All I see here is posturing that HIV doesn't cause AIDS... on the linked web site there is even someone claiming the "HIV-virus" doesn't even exist.
- iframe 14y agoJust check "how HIV tests are taken" , they don't even have virus to compare with, they just count your AntiBodies ..