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German AIDS experts question the cure of the child infected with HIV
A baby infected with HIV is said to have been cured, according to US doctors. This became known on Monday when the case of the now two-and-a-half-year-old Mississippi girl was presented at the CROI (Congress on Retroviruses and Opportunistic Infections) in Atlanta. As the virologist Deborah Persaud reported, the early massive intervention by the doctors meant that the disease in the child would very likely not break out later. However, German experts have doubts about the functional healing of the girl.
Immune system can control residual HI viruses without medication As the US virologist led by Deborah Persaud from the Johns Hopkins University in Baltimore reported, the child had been almost completely freed from the HI virus. The amount of viruses that can still be detected in the body of the little patient has meanwhile decreased so much that the body's immune system can cope with it without medication. Doctors therefore speak of a “functional cure”. The virus would very likely not lead to the outbreak of AIDS in the girl. The child had not been on medication for a year without any signs of HIV infection. The doctors now hope that the case will provide insights into how HIV is cured in children.
Child's HIV virus hardly detectable after one month of therapy Doctors only learned of the baby's mother's HIV infection shortly before birth in 2010. Until then, she had not received any medication to reduce the risk of infecting her child. The newborn was therefore immediately treated with a combination of three drugs, a so-called antiretroviral therapy. As the doctors reported, the little girl's viral load was surprisingly barely detectable after just one month. The early treatment most likely resulted in the virus not nesting in difficult-to-treat sleeping cells, explained Deborah Persaud. These virus reservoirs are unreachable for medication and could cause a new outbreak if therapy is stopped. However, the fact that the child showed no signs of infection after stopping the medication confirms this assumption.
The mother had interrupted the girl's therapy after 18 months and did not see the doctors again until ten months later. In the child's blood test, four virus copies per microliter of blood were detected, Deborah Persaud reported. As the "FAZ" reports, nothing is known about the child's current state of health, since the mother and child have disappeared.
German HIV experts doubt the cure of the HIV-infected baby In an interview with the “Deutschland Welle”, the HIV experts Norbert Brockmeyer and Jürgen Rockstroh from the University Clinic Bonn were skeptical about the cure of the HIV-infected baby. The news from the United States was of great interest, "but was received with skepticism," reported Norbert Brockmeyer. During the congress, the case of the girl was discussed in detail, but doubts arose. "I wonder if the child was really infected or whether it was rather a successful post-exposure prophylaxis, "said Brockmeyer. Such preventive therapy is started as soon as possible, within 24 hours after the person is most likely infected with HIV. This can be the case, for example, if medical personnel injure themselves on a syringe and accidentally come into contact with infected blood. Emergency treatment is intended to prevent the virus from implanting in the body. Brockmeyer therefore does not believe that the child was actually a cure for a fixed infection.
Jürgen Rockstroh also had a few questions: “Has HIV replication been initiated? Or has this been prevented - as in other cases in which we give prophylaxis? "There is no evidence that the HIV has already nested and multiplied in the child's cells. Only if this is the case Brockmeyer says that "healing can be said." Before I get more data from my colleagues, the case is a hint for me: We are on the way. " At this point it is not possible to say whether the little girl was actually healed or received very effective prophylaxis. However, the case shows how important it is to start treatment as early as possible, according to the expert. (ag)
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