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An “Immunological Cure” of HIV Infection?

The New York Times announced recently that an infant born to an HIV+ mother treated with antivirals within 30 hours after birth is “cured” of HIV infection. The baby was found to be HIV+ just after birth and was treated with a 3-drug combination for 18 months, after which the mother discontinued the drugs. When seen 6-months later the virus was undetectable in the blood. Other details remain to be reported, but if confirmed that the child’s immune system has contained residual virus, this case is important, because it is proof of principle that if the antivirals are given soon enough after infection, so that damage to the immune system does not occur, then any residual virus can be kept under control by a normal immune system, i.e. an “immunological cure”. Thus, current pediatrics treatment practices may be changed. As regards the vast majority of adults chronically infected with HIV who are taking life-long antivirals, the importance of this pediatric case is that it demonstrates that attention should now be shifted to the immune system, with immunotherapy designed to repair the damages inflicted by prolonged viral infection and the ineffectual immune response. It is clear now that the antivirals alone cannot repair the immune system, so that if that can be accomplished, immunological cures will allow the toxic antivirals to be eventually discontinued.

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