French scientists urge caution over HIV 'cure'
US scientists say they have cured a baby born with HIV for the first time, in a case that could lead to significant advancements in treatment for infected children. But the two leading HIV specialists in France are urging caution.
“It’s an incredible story, and totally unique,” French doctor and journalist Jean-Daniel Flaysakier wrote on his medical blog on Sunday.
A baby born with HIV has been cured with what has been called a “functional” -- rather than “complete” -- cure by using antiretroviral drugs administered less than 30 hours after her birth.
Though the virus has not been entirely eliminated, its levels are so low that the baby's body can control it without further treatment.
The news was announced on Sunday by US researchers at the 20th annual Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta, Georgia.
The mother of the child was HIV-positive, though she did not know it during her pregnancy (she had not consulted a doctor before giving birth).
After the antiretroviral drugs were administered for 18 months, the baby no longer needed any treatment, and the virus has not returned. The child is now two-and-a-half years old.
“What’s exceptional here is that the treatment was stopped,” explained Jean-François Delfraissy, director of France’s National Agency for AIDS Research, in an interview with FRANCE 24. “And none of the baby’s blood tests have detected any trace of HIV, despite the fact that she is no longer receiving the drugs.”
Possible reactivation of the virus?
However, the considerable enthusiasm generated by the news is not fully shared by all AIDS specialists.
Professor Luc Montagnier, widely credited for discovering the AIDS virus, has called for “caution,” for two main reasons. One is that the medical profile of the child concerned is rare. “Only one third of babies born from HIV-positive mothers who have not been treated are infected by the virus,” he told FRANCE 24. “70% are healthy at birth.”
Furthermore, there is no guarantee that the virus -- currently dormant but not fully destroyed by the immune system or the treatments -- will not be reactivated at any given moment.
“One would need to follow up with the child periodically to know whether or not the virus will return or not,” Montagnier said. “It all depends on the persistence of the ‘reservoir’ [the group of cells in which the virus can lie dormant for several years].”
Mainly ‘interesting for research’
Delfraissy agrees with Montagnier on that last point.
“One would need several years to pass before we can call this a ‘cure’,” he said. “We don’t yet know if the virus will wake up and release new viral particles.”
Most of all, Delfraissy pointed out, the news should in no way change the course of treatment for patients.
“This discovery, as exceptional as it is, is only interesting from a scientific standpoint. What’s going on inside this child’s body? What gave the child the capacity to control the infection?” he said.
“It’s a fascinating issue for researchers. But it doesn’t change the medical procedures and practices in place for these patients, who must not stop their treatments.”
In July 2012, a study carried out by France’s National Agency for AIDS Research already identified a “functional” cure in a group of adult patients who had received very early and aggressive treatment (within the first 10 weeks after infection).
After an average of three weeks of treatment, the patients were able to stop taking the medication, and were able to live with a nearly undetectable viral presence. Six years later, the virus has still not been reactivated.
It is another small victory in what has proved a long march to find a cure.