HIV-Infected Babies Have a Greater Chance of Remission with Early Treatment

A Botswana study found that HIV-infected babies who are given treatment right away have very little virus in their blood.


Centers for Disease Control

HIV ATTACKS: HIV budding (in green) from a lymphocyte. The image has been colorized to emphasize important features.

By Stephanie Caceres, Staff Writer

In 2018, 160,000 kids worldwide were infected with HIV through pregnancy, birth or breastfeeding. Now a Botswana study finds that if newborns are given treatment right away, the virus almost completely resolves. 

If a baby tests positive for HIV, sub-Saharan countries conventionally give them treatment weeks or months after they are born. The concern is that newborns can’t tolerate these powerful drugs.

Dr. Deborah Persaud, a virologist at Johns Hopkins Children’s Center, co-wrote a paper in 2013 about a baby girl in Mississippi with HIV who was treated 30 hours after birth.

At 18 months, the girl was taken off antiretroviral drugs, and for 27 months, there was no sign of HIV.

Doctors suspected  early treatment was responsible for the baby’s two years of drug-free healthy living. Since then, it has become standard practice for doctors in the U.S. to treat babies at high risk of being born with HIV soon after birth.

However, researchers still believed that more clinical evidence was needed that the treatment was safe done early rather than delaying it.

The clinical trial in Botswana gave ten HIV-positive babies a three-drug cocktail within their first days. The researchers reported that two years out, the babies had very little virus in their body. They aren’t cured but it is possible that the babies will have long-term remission of their HIV. 

The kids that started drugs months after birth had 200 times more virus in their blood than those given treatment right away.

By giving the babies early treatment, HIV was limited to establishing reservoirs in the body where the virus hides.

Doctors believe the greatest hardship is getting the drugs to babies that need them.

Many countries do not have the infrastructure needed to support treatment.

About half the babies in sub-Saharan Africa infected with HIV don’t have access to antiretroviral drugs.