'Mississippi' trial

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01 Dec 2014

A global trial is underway to better understand how administering antiretroviral treatment (ART) to HIV-infected newborns can potentially functionally cure them of the disease.

The study — being conducted in the US at the National Institutes of Health — was initiated by the so-called ‘Mississippi baby’ case. After receiving ART 30 hours after birth and remaining on treatment for the next two years, the Mississippi baby appeared to be HIV-free. However, earlier this year the virus had returned to detectable levels. Even so, the case gave hope that HIV has an Achilles’ heel.

“Even though people were disappointed that the Mississippi baby rebounded, the fact that the child was off antiretrovirals for 27 months was unheard of,” said Dr Yvonne Bryson, co-chair of the trial. “Early treatment of that baby still made a tremendous difference on the amount of virus in the body.”

Involving almost 500 babies from eight nations — the United States, Argentina, Brazil, Uganda, Malawi, Zambia, Zimbabwe and South Africa — the trial (called IMPAACT P1115) will see HIV newborns given intensive ART within 48 hours of birth. After two years of treatment, the children will come off medication for as long as they retain an undetectable viral load.

“Our hope is that some of them, or perhaps one of them, will stay in remission or be cured,” said Bryson. “Even if we find that a lot of these babies might have a virus rebound, we’ll learn a lot about how long it’s been gone and also whether or not we would add in a vaccine or another drug to make the remission even more prolonged.”