UNAIDS and UNICEF welcome news of a baby born with HIV who now as a toddler appears “functionally cured” through treatment And looks forward to further studies to see if findings can be replicated

 

UNAIDS and UNICEF welcome news of a baby born with HIV who now as a toddler appears “functionally cured” through treatment And looks forward to further studies to see if findings can be replicated

GENEVA/ HONG KONG, 4 March 2013 — The Joint United Nations Programme on HIV/AIDS (UNAIDS) and UNICEF welcome a new case study, which found a baby treated with antiretroviral drugs in the first 30 hours of life and who continued on HIV treatment for 18 months appeared to be functionally cured.

A youth counsellor collects a blood sample from an individual, for HIV testing, at a mobile voluntary counselling and testing site set up by the UNICEF-supported NGO Research and Integrated Development Centre (RICDC), in the city of Ganta in Nimba County. The Centre also has youth volunteers who provide voluntary counselling and testing for the general public and raise awareness about HIV/AIDS.  In April/May 2012 in Liberia, the Government continues to rebuild infrastructure and basic social services destroyed during 14 years of civil war that ended in 2003. Long-term national policies and strategies are improving the health and nutrition status of Liberian children and women. However, despite substantial progress, economic, social and development challenges remain. The country remains one of the world’s poorest, with 64 per cent of the population living below the poverty line. Many Liberians still lack access to basic services, and rising food prices are among factors that affect household food and nutrition security. Malnutrition is a primary cause of under-5 mortality in the country, and chronic malnutrition remains high. An estimated 42 per cent of children under age five are stunted. The situation is exacerbated by the influx of an estimated 178,000 refugees from neighbouring Côte d'Ivoire, who fled violence in their home country following the 2010 presidential election there. Although many have returned home, approximately 135,000 remaining refugees continue to strain already limited resources. Working with the Government, NGOs and other partners, UNICEF supports a range of child nutrition programmes, as well as other health, water, sanitation and hygiene (WASH), education and protection interventions. Madina, 9, [NAME CHANGED], who is HIV-positive, paints at the UNICEF-supported Kaldirgoch Day Care Centre, in the city of Tashkent, the capital. The centres provide psychosocial care, medical and legal counselling and an environment free of stigma and discrimination to children with HIV/AIDS and their families. Madina is participating in art therapy, which encourages children to express themselves and to connect with others. [#3 IN SEQUENCE OF THREE]  In July 2011 in Uzbekistan, UNICEF is working closely with the Government to improve conditions for children, particularly in the areas of health and education. While child mortality rates have decreased significantly, some 20,000 under-5 children still die each year. Further, more than 10 per cent of eligible primary school children do not attend school. In addition to programme and advocacy support, UNICEF is currently running a Multiple Indicator Cluster Survey (MICS) in the country. This is part of the fourth round of MICS, scheduled for 2009 – 2011, that is helping countries measure their progress in achieving national and international child survival and development goals, including the United Nations Millennium Development Goals (targeted for achievement in 2015). MICS data is collected in face-to-face interviews in nationally representative samples of households, generating one of the world’s largest sources of statistical information on children and women. Since the mid-1990s, MICS have enabled more than 100 countries to produce statistically sound and internationally comparable estimates of a range of health, education, child protection and other indicators.

 

The findings were presented today at the Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta, Georgia in the United States of America.

 

According to researchers the mother who was living with HIV at the time of birth had not received antiretroviral (ARV) medication or prenatal care. Researchers say that the child was born prematurely in July 2010 in the state of Mississippi. Due to the high risk of exposure to HIV, the researchers say the baby was started on a triple therapy regimen of antiretroviral drug 30 hours after birth and before proof of infection could be confirmed. The newborn’s HIV-positive status was subsequently confirmed through a highly sensitive polymerase chain reaction testing which was conducted on several occasions.

The case study stated that the baby was discharged from the hospital after one week and continued ARV treatment until 18 months of age, when for reasons that are unclear the treatment was discontinued. However, when the child was seen by medical professionals about a half a year later, blood samples revealed undetectable HIV levels and no HIV-specific antibodies.
A health worker holds ARV medications and a glass of water in her hands at a child care centre in Tondo, a neighbourhood of Manila, the capital. Behind her, an HIV-positive child sits with a caregiver. The centre is run by Precious Jewels Ministry, a UNICEF-assisted centre NGO that offers medical assistance, educational activities and counselling for AIDS-affected children, as well as community outreach to raise awareness of HIV/AIDS and combat the stigma associated with the disease.  In 2006 in the Philippines, HIV transmission is hidden and growing. While official statistics cite fewer than 10,000 HIV cases nationwide, high-risk behaviours, especially among adolescents, are on the rise. Those at highest risk are children in depressed, urban areas, those who live or work in the streets and those involved in the sex industry. Many have limited access to basic services like education, community support and health care. And a strong culture of stigma, denial and silence has prevented an open discussion of HIV/AIDS, sexuality and adolescent reproductive health. Other factors impeding prevention and care services include limited knowledge and skills among health-care workers; rapid turnover and migration of staff; and disruption of health systems due to emergencies and conflict. On Mindanao Island, a decades-long conflict between Christians and Muslims has killed, injured or displaced thousands of children, and left others vulnerable to abduction, trafficking and abuse. Working with government, NGO and other partners, UNICEF supports peer counselling and prevention awareness training for adolescents; expanded voluntary counselling and testing services; and treatment, care and support services for children infected with HIV/AIDS. UNICEF also supports child protection, peace building and the delivery of social services in conflict areas.
If the findings are confirmed this would be the first well-documented case of an HIV-positive child who appears to have no detectable levels of the virus despite stopping HIV treatment.

 

20130304_hivbaby_6 UNICEF Executive Director Anthony Lake gives welcome and opening remarks at the UN H4+ High-Level Breakfast Meeting at UNICEF House.  On 24 September 2012 at UNICEF House, a high level breakfast meeting of the United Nations Health 4+ was held to review country-level progress and challenges to improve maternal, newborn and child health. The group – known as the H4+ – is a partnership originally led by four UN agencies: the United Nations Population Fund (UNFPA), UNICEF, the World Bank and the World Health Organization (WHO). These have recently been joined by the Joint United Nations Programme on HIV/AIDS (UNAIDS), UN Women and other partners. Effective this month, UNICEF is the lead coordinator of the H4+ partnership for one year. H4+ initiatives build on each partner’s strengths to help accelerate progress toward achieving related Millennium Development Goals (MDGs), in line with the Secretary-General’s Global Strategy for Women and Children’s Health. Also under the umbrella of the Global Strategy, a global partnership – under the banner ‘Committing to Child Survival: A Promise Renewed’ – aims to accelerate gains in reducing maternal and child survival by: revitalizing the global movement for child survival, supporting evidenced-based country plans, and enhancing transparency and accountability to reduce child mortality to 20 or fewer deaths per 1,000 live births by 2035. At the H4+ meeting, in addition to agency heads from UNFPA, UNICEF, UNAIDS and WHO, attendees included the First Ladies of Zambia and South Africa, as well as other senior government and agency representatives. The meeting is one of many events taking place in the context of the 65th session of the UN General Assembly, which opened at UN Headquarters on 18 September.

 

“This news gives us great hope that a cure for HIV in children is possible and could bring us one step closer to an AIDS free generation,” said UNAIDS Executive Director Michel Sidibé. “This also underscores the need for research and innovation especially in the area of early diagnostics.”

In 2011, UNAIDS and its partners launched a Global plan for the elimination of new HIV infections among children by 2015 and keeping their mothers alive. Significant progress has been made and continued support and research is needed.

A woman living with HIV embraces her daughter in the maternal and child health unit at Moundou Hostpial in Moundou, the capital of Logone Occidental Region. The woman participated in a UNICEF-supported programme to prevent mother-to-child transmission of HIV (PMTCT). Her daughter is HIV-negative.  In April 2011 in Chad, malnutrition – a preventable condition – remains one of the greatest threats to children’s right to survival and development. One out of every five of Chad’s children dies before her/his fifth birthday. More than 100,000 of the country’s children aged 0–5 are malnourished, and 1 out of every 10,000 dies each day. Though chronic food insecurity is the main underlying cause of malnutrition, widespread poverty, rising food prices, desertification and climate change all play a part in this silent emergency. UNICEF is working with the Ministry of Health and other partners to improve community-based interventions structured around 205 nutrition centres throughout Chad’s Sahel belt. Between January and October 2011, these centres treated approximately 56,000 under-five children suffering from severe acute malnutrition. The effects of chronic malnutrition have only been exacerbated by conflict – both internal and external – that has left hundreds of thousands of internally displaced persons as well as refugees from Sudan and the Central African Republic dependent upon aid for survival. In addition to nutrition, UNICEF is also supporting programmes in other vital sectors, including education, health care, WASH (water, sanitation and hygiene) and child protection, for both Chadian and refugee communities. UNICEF is requesting US$46.4 million to continue ongoing assistance for the country’s most vulnerable in 2012.
“While we wait for these results to be confirmed with further research, it is potentially great news,” said UNICEF Executive Director, Anthony Lake. “This case also demonstrates what we already know—it is vital to test newborn babies at risk as soon as possible.”
According to data from the World Health Organization and UNICEF only 28 per cent of HIV-exposed babies were tested for HIV within six weeks of birth in 2010. Obstacles to early diagnosis and treatment include the high cost of diagnostics and difficulty of getting timely results and limited access to services and medicines. There were 330,000 children newly infected with HIV in 2011. At the end of 2011, 28 per cent of children under the age of 15 living with HIV were on HIV treatment, compared to 54 per cent of eligible adults.

Now two and a half year’s old, the toddler continues to thrive without antiretroviral therapy and has no identifiable levels of HIV. However, UNAIDS cautions that more studies need to be conducted to understand the outcomes and whether the current findings can be replicated.