Child Offers Aids Researchers Hope Born Hiv-Positive, 5-Year-Old Now Shows No Sign Of Infection
UCLA researchers say they have documented a case for the first time in which an infant infected with the AIDS virus at birth had cleared the virus from his body by his first birthday.
The child, now 5, is healthy and shows no evidence of ever having been infected by HIV.
The report, published today in the New England Journal of Medicine, confirms what researchers had suspected was possible but never had been proved - that the human immune system can fend off the AIDS virus. By studying the phenomenon, they hope to gain insight for developing an AIDS vaccine.
“This tells us something very important,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, “that there are situations where you can get infected and clear the virus. There must be some mechanism available in the body capable of doing that. If we look carefully enough, we may be able to (find it).”
Several similar cases have been reported in the literature previously, but all have been dismissed as the result of laboratory errors. Dr. Yvonne J. Bryson and her UCLA colleagues report that they have used sophisticated molecular biology techniques to show without a doubt that the child was infected and that the virus has since disappeared from his body.
The discovery is important, Bryson said, because, “If it happens once, particularly in an infant, it may happen more often.”
The results, she said, may explain why 70 percent of infants born to HIV-positive mothers do not themselves develop the disease. It also may shed new light on the mechanisms by which some spouses of HIVpositive individuals and some groups of African prostitutes are able to avoid infection.
But Bryson cautioned mothers of HIV-positive infants not to build up their hopes solely on the basis of her report. “I don’t want this to be misconstrued by mothers,” she said. “This is a relatively rare thing.”
Bryson also said the team has tentatively identified a second child, a girl, that they believe has recovered from an HIV infection, and they are now doing the extensive molecular testing necessary to confirm this possibility. But, she noted, these are only two cases out of more than 170 mother/infant pairs that they have examined in an ongoing study of babies born to HIV-infected mothers. The researchers are keeping the identity of the two children confidential.
In an accompanying editorial in the same issue of the journal, Drs. Kenneth McIntosh and Sandra K. Burchett of Children’s Hospital in Boston noted that several similar reports had previously been published, but noted that those researchers could not confirm the children had been infected in the first place. That lack of documentation left open the possibility that the initial positive HIV test could have resulted from contamination of the infant’s blood sample in the laboratory or an inadvertent mixing of specimens.
“I was skeptical myself,” Bryson said.
To show that such errors did not occur, Bryson and her colleagues, including Dr. Irvin S. Y. Chen, director of the UCLA AIDS Institute, ruled out lab contamination by showing that the genetic composition of the virus isolated from the infant’s specimens was virtually identical to that of the virus isolated from his mother.
They also did DNA fingerprinting of the blood cells from which the virus was isolated and showed that those fingerprints were identical to fingerprints from a new sample of the child’s blood, thereby eliminating the possibility of mixed-up samples.
“In light of the new case,” McIntosh and Burchett wrote, “it seems that perhaps they (the previous cases) were not errors, or at least not all of them.”
xxxx MOMS WITH AIDS According to the Centers for Disease Control and Prevention, about 7,000 mothers who are infected with the AIDS virus give birth each year. About 2,000 of those babies contract the virus from their mothers.