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Case Reports
. 2013 Nov 7;369(19):1828-35.
doi: 10.1056/NEJMoa1302976. Epub 2013 Oct 23.

Absence of detectable HIV-1 viremia after treatment cessation in an infant

Deborah Persaud  1 , Hannah Gay, Carrie Ziemniak, Ya Hui Chen, Michael Piatak Jr, Tae-Wook Chun, Matthew Strain, Douglas Richman, Katherine Luzuriaga
Affiliations
Case Reports

Absence of detectable HIV-1 viremia after treatment cessation in an infant

Deborah Persaud et al. N Engl J Med. .

Abstract

An infant born to a woman with human immunodeficiency virus type 1 (HIV-1) infection began receiving antiretroviral therapy (ART) 30 hours after birth owing to high-risk exposure. ART was continued when detection of HIV-1 DNA and RNA on repeat testing met the standard diagnostic criteria for infection. After therapy was discontinued (when the child was 18 months of age), levels of plasma HIV-1 RNA, proviral DNA in peripheral-blood mononuclear cells, and HIV-1 antibodies, as assessed by means of clinical assays, remained undetectable in the child through 30 months of age. This case suggests that very early ART in infants may alter the establishment and long-term persistence of HIV-1 infection.

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Figures

Figure 1
Figure 1. Detection of Human Immunodeficiency Virus Type 1 (HIV-1) Infection in the Child
Panel A shows HIV-1 RNA levels indicating confirmed HIV-1 infection, with positive values for HIV-1 RNA in plasma at four time points before and after the initiation of antiretroviral therapy (ART). The decline in the viral load was biphasic, which is typically seen during effective ART. Panel B shows HIV-1 RNA levels indicating sustained control of HIV-1 replication during ART and after the discontinuation of therapy. The solid arrow indicates the last time that prescriptions for ART were filled (at 15 months of age, according to pharmacy records), and the dashed arrow the time of the last administration of ART (at 18 months of age, according to maternal report). In both Panel A and Panel B, solid circles indicate detectable HIV-1 RNA, and open circles undetectable HIV-1 RNA; the shaded area indicates the limit of detection of the plasma viral-load assay. Panel C shows the percentage of CD4+ T cells from the child’s birth until 30 months of age. The shaded area indicates the CD4+ T-cell percentage in the normal range (10th to 90th percentiles); fluctuations in the normal range are due to age-related changes. 3TC denotes lamivudine, AZT zidovudine, and NVP nevirapine.
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References

    1. UNAIDS. World AIDS Day global report. 2012 ( http://www.unaids.org/en/resources/campaigns/20121120_globalreport2012)
    1. Hütter G, Nowak D, Mossner M, et al. Long-term control of HIV by CCR5 Delta32/Delta32 stem-cell transplantation. N Engl J Med. 2009;360:692–8. - PubMed
    1. Allers K, Hütter G, Hofmann J, et al. Evidence for the cure of HIV infection by CCR5 Delta32/Delta32 stem cell transplantation. Blood. 2011;117:2791–9. - PubMed
    1. Guidelines for the use of anti-retroviral agents in pediatric HIV infection. Rockville, MD: AIDSinfo; 2012. Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children. ( http://aidsinfo.nih.gov/guidelines/html/2/pediatric-treatment-guidelines/0)
    1. FDA Drug Safety Communication. Serious health problems seen in premature babies given Kaletra (lopinavir/ritonavir) oral solution. Silver Spring, MD: Food and Drug Administration; 2011. ( http://www.fda.gov/Drugs/DrugSafety/ucm246002.htm)

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