ddPCR helps prove baby cured of HIV.pdf

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    PCR IN VIRUS RESEARCH: BABYS HIV

    INFECTION APPARENTLY CURED

    POSTED ON MARCH 13, 2013 BY SUZANNE

    Like 3 Tweet 3 0 7

    The polymerase chain reaction (PCR) has played a role in the first ever documented

    caseof a child infected with HIV apparently being cured.

    The childs mother was HIV positive, though she wasnt aware of this until she was

    tested while in labour, and the child, born in Mississippi, was diagnosed with HIV

    infection at birth, using standard HIV DNA PCR and plasma viral load. When a

    pregnant woman is known to be HIV positive, she is usually given antiretroviral drugs

    to prevent her from passing the infection on to the baby, but in this case, it was too

    close to birth for it to work.

    Unusually, the baby received an aggressive course of three antiretroviral drugs from

    30 hours after birth. Even though the mother stopped giving the drugs to the child

    after 18 months, when the child came back into hospital at 23 months, the viral load

    was undetectable, even with a battery of the most sensitive tests available, including

    ultrasensitive HIV DNA droplet digital PCR, plasma viral load (single copy) assays, and

    quantitative co-culture assays.

    The childs paediatrician in Mississippi was aware of the work we were doing, and

    quickly notified our team as soon as this young patients case came to her attention,said Rowena Johnston, sponsor amfARsvice president and director of research.

    Source: NIH, redrawn by Carl

    Henderson

    The negative result came as a surprise to the doctors, as they had expected that the

    viral levels would have risen significantly, and has been described as a functional cure

    (when standard tests can find no virus but it is likely that a trace remains in the

    body).

    The researchers believe that this unnamed baby now has the chance of a healthy life

    without having to rely on anti-HIV medication. This is a single case so no firm

    conclusions can be drawn. However, it appears that the early treatment stopped HIV

    from infecting the CD4 cells, the white blood cells that harbour HIV long-term.

    If the results can be replicated, this case in Mississippi could point to a potential low-

    cost approach to treating HIV infection in newborns. However, there is an ethical

    issue with taking babies and children off effective therapies, and the best approach

    will still be prevention. Treating pregnant women with antivirals can prevent 98-99%

    of infections in newborns.

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    Babys HIV infection

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    In adult patients, the CD4 cells are generally already infected at diagnosis, and lead

    to re-infection when treatment is stopped, so the approach that worked in the baby

    would not be appropriate. So, despite the media flurry surrounding this case, while

    knowing more about the babys immune response could potentially lead to new

    strategiesfor treatments and perhaps even cures, these are still a very long way off.

    There has been one documented case of an HIV cure in an adult Timothy Brown,

    also known as the Berlin patient. He was diagnosed with leukaemia while being

    treated for HIV, and received a stem cell transplant from a patient with a mutation

    that leads to immunity to HIV infection, apparently treating both his leukaemia and

    his HIV.

    Suzanne Elvidge is a freelance science, biopharma, business and health writer with

    more than 20 years of experience. She is editor of Genome Engineering, a blog that

    monitors the latest developments in genome engineering and that aims to educate

    (and sometimes to entertain!) and has written for a range of online and print

    publications including FierceBiomarkers, FierceDrugDelivery, European Life Science,

    the Journal of Life Sciences (now the Burrill Report), In Vivo, Life Science Leader,

    Nature Biotechnology, PR Week and Start-Up. She specialises in writing on

    pharmaceuticals, biotechnology, healthcare, science, lifestyle and green living, but

    can write on any topic given enough tea and chocolate biscuits. She lives just beyond

    the neck end of nowhere in the Peak District with her second-hand bookseller

    husband and two second-hand cats.

    Tags: AIDSantiretroviral drugsCD4 cellscuredroplet digital PCRfunctional cureHIV

    DNAHIV infectionPCRpolymerase chain reactionviral loadvirus research

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