A baby infected with HIV appears to be free of the virus after doctors at a Long Beach hospital initiated aggressive drug treatment just four hours after birth.
A pediatrician at Miller Children's Hospital Long Beach and her colleagues disclosed the case Wednesday at a Boston AIDS conference.
The newborn girl was initially confirmed to have HIV through blood and spinal fluid tests. However, after six days of treatment with antiretroviral drugs, the virus could no longer be detected, doctors said.
The girl, who was born in April and is being referred to as the "Los Angeles baby," remains on three standard HIV medications. Because of this, doctors cannot say for certain yet whether the infant is cured or whether the disease has gone into remission.
"This is uncharted territory," said Dr. Yvonne Bryson, an infectious disease specialist at Mattel Children's Hospital UCLA, who consulted on the Los Angeles baby's care. "The only way we know that we really have remission is to stop therapy."
The news comes almost one year after another group of physicians announced for the first time that an HIV-infected infant in Mississippi had been "functionally cured" of the disease following similar drug treatment.
Dr. Audra Deveikis, a pediatric infectious disease specialist at Miller Children's Hospital, said the baby would continue to undergo drug treatment out of caution. She and Bryson said the decision on when to remove the infant from treatment would be based on an upcoming clinical trial involving 60 infant HIV cases.
"The decision of when to stop therapy is not something we're going to take lightly," Deveikis said. "We're going to continue for at least two years, or longer, depending on the information we get from these future studies."
In the case of the so-called Mississippi baby, doctors began treating the newborn with drugs 30 hours after birth. Within a month the virus was undetectable.
Although doctors recommended that the medication continue, the mother stopped giving the Mississippi baby anti-HIV drugs after 18 months. The child, who is now 3 1/2 years old, remains healthy, roughly two years after treatment ceased.
In the case of the Los Angeles baby, Deveikis knew the mother from a previous pregnancy. She was aware that the mother was infected with HIV and not taking her medication. The doctor prepared a treatment plan based on the Mississippi case.
The Los Angeles baby is now in foster care, doctors said during Wednesday's presentation.
Bryson is also helping to oversee the federally funded study looking into when HIV-infected infants can be removed from aggressive drug treatment once they no longer show signs of the virus.
"The clinical trial that we're about to start has specific criteria to stop therapy and to restart it if the virus comes back," Bryson said.
The clincial trial is scheduled to begin in roughly two months and does not include the Los Angeles baby, she said.