Second baby with AIDS virus successfully treated on heels of Mississippi medical first

The University of Mississippi Medical Center’s Dr. Hannah Gay certainly must be feeling a little déjà vu today.

The pediatric HIV specialist is at the 2014 Conference on Retroviruses and Opportunistic Infections in Boston, the same gathering where a year ago a team of physicians including Gay announced publicly that Gay put into remission and functionally cured a Mississippi baby born with the AIDS virus.

Today at the conference, doctors revealed a Los Angeles baby born with the AIDS virus also may be in remission and possibly cured because she, like the Mississippi baby, began treatment very soon after birth.

The Mississippi case, a medical first, led researchers worldwide to re-evaluate how quickly and aggressively infants born with the AIDS virus should be treated. Doctors didn’t know the Mississippi baby’s mother had HIV until she was in labor. They began treating the baby for the AIDS virus within 30 hours of her birth, even before tests showed she was positive.

Treatment was started for the Los Angeles baby four hours after her birth, researchers at the Boston conference said today.

The parallels of the cases – and the fact that Mississippi’s medical first spurred similar treatment of the Los Angeles baby – are featured in some of the conference presentations.

Because the Los Angeles baby is still on antiviral medications, it’s not known if her infection is totally gone. But in the Mississippi baby’s case, she appears HIV free at age three and a half.

“The Mississippi baby continues to be followed carefully at the University of Mississippi Medical Center’s pediatric clinic. She has not taken any HIV medications for almost two years, and her virus has not returned. We are thrilled that she continues to do so well,” Gay said in a statement.

Gay and her colleagues, Dr. Deborah Persaud, a Johns Hopkins Children’s Center virologist, and Dr. Katherine Luzuriaga, a University of Massachusetts Medical School immunologist, presented their findings at the 2013 CROI conference In Atlanta.

Persaud led the testing of the Los Angeles baby, whose mother had not been taking her HIV medications during her pregnancy.

A host of sophisticated tests at multiple times suggest the LA baby has completely cleared the virus, Persaud said. The baby's signs are different from what doctors see in patients whose infections are merely suppressed by successful treatment, she said.

"We don't know if the baby is in remission ... but it looks like that," said Dr. Yvonne Bryson, an infectious disease specialist at Mattel Children's Hospital UCLA, who consulted on the girl's care.

Doctors are cautious about suggesting the Los Angeles baby has been cured, "but that's obviously our hope," Bryson said.

Most HIV-infected mothers in the United States get antiviral medicines during pregnancy, which greatly cuts the chances they will pass the virus to their babies. Because the Mississippi baby's mom received no prenatal care and her HIV was discovered during labor, doctors knew that infant was at high risk.

The LA baby was born at Miller Children's Hospital Long Beach, and "we knew this mother from a previous pregnancy" and that she was not taking her HIV medicines, said Dr. Audra Deveikis, a pediatric infectious disease specialist at the hospital.

The mom was given antiviral drugs during labor to try to prevent transmission of the virus, and Deveikis started the baby on them a few hours after birth. Tests later confirmed she had been infected, but does not appear to be now, nearly a year later.

The baby is continuing treatment, is in foster care "and looking very healthy," Bryson said.

The Mississippi girl was treated until she was 18 months old, when doctors lost contact with her. Ten months later when she returned, they could find no sign of infection, even though the mom had stopped giving her antiviral medicines.

Bryson is one of the leaders of a federally funded study just getting under way to see if very early treatment can cure HIV infection. About 60 babies in the U.S. and other countries will get very aggressive treatment that will be discontinued if tests over a long time, possibly two years, suggest no active infection.

"These kids obviously will be followed very, very closely" for signs of the virus, Persaud said.

"My goal is to make sure that we don't have any more transmissions from mother to infant in Mississippi before I retire,” Gay told The Clarion-Ledger in a July 2013 interview.

The Associated Press contributed.