In Medical First, a Baby With H.I.V. Is Called Cured

By ANDREW POLLACK and DONALD G. McNEIL Jr.

Doctors announced on Sunday that a baby had been cured of an H.I.V. infection for the first time, a startling development that could change how infected newborns are treated and sharply reduce the number of children living with the virus that causes AIDS.

The baby, born in rural Mississippi, was treated aggresively with antiretroviral drugs starting around 30 hours after birth, something that is not usually done. If further study shows this works in other babies, it will almost certainly change the way newborns of infected mothers are treated all over the world. The United Nations estimates that 330,000 babies were newly infected in 2011, the most recent year for which there is data, and that more than 3 million children globally are living with H.I.V.

If the report is confirmed, the child born in Mississippi would be only the second well-documented case of a cure in the world, giving a boost to research aimed at a cure, something that only a few years ago was thought to be virtually impossible.

The first person cured was Timothy Brown, known as the “Berlin patient,’’ a middle-aged man with leukemia who received a bone-marrow transplant from a donor genetically resistant to H.I.V. infection.

“For pediatrics, this is our Timothy Brown,’’ said Dr. Deborah Persaud, associate professor at the Johns Hopkins Children’s Center and lead author of the report on the baby. “It’s proof of principle that we can cure H.I.V. infection if we can replicate this case.’’

Dr. Persaud and other researchers spoke in advance of a presentation of the findings on Monday at the Conference on Retroviruses and Opportunistic Infections in Atlanta.

Some outside experts, who have not yet heard all the details, said they needed convincing that the baby had truly been infected. If not, this would be a case of prevention, something already done for babies born to infected mothers.

“The one uncertainty is really definitive evidence that the child was indeed infected,” said Dr. Daniel R. Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital.

Dr. Persaud and some other outside scientists said they were certain the baby – whose name and gender were not disclosed – had been infected. There were five positive tests in the baby’s first month of life – four for viral RNA and one for DNA. And once the treatment started, the virus levels in the baby’s blood declined in the pattern characteristic of infected patients.

Dr. Persaud said there was also little doubt that the child experienced what she called a “functional cure.” Now 2½ , the child has been off drugs for a year with no sign of functioning virus.

The mother arrived at a rural hospital in the fall of 2010 already in labor and gave birth prematurely. She had not seen a doctor during the pregnancy and did not know she had H.I.V. When a test showed the mother might be infected, the hospital transferred the baby to the University of Mississippi Medical Center, where it arrived at about 30 hours old.

Dr. Hannah B. Gay, an associate professor of pediatrics, ordered two blood draws an hour apart to test for the presence of H.I.V. RNA and DNA.

The tests found a level of virus at about 20,000 copies per milliliter, fairly low for a baby. But since tests so early in life were positive, it suggests the infection occurred in the womb rather than during delivery, Dr. Gay said.

Typically a newborn with an infected mother would be given one or two drugs as a prophylactic measure. But Dr. Gay said that based on her own experience, she almost immediately used a three-drug regimen aimed at treatment, not prophylaxis, not even waiting for the test results confirming infection.

Virus levels rapidly declined with treatment and were undetectable by the time the baby was a month old. That remained the case until the baby was 18 months old, after which the mother stopped coming to the hospital.

When the mother and child returned five months later, Dr. Gay expected to see high viral loads in the baby. But the tests were negative.

Suspecting a laboratory error, she ordered more tests. “To my greater surprise, all of these came back negative,” Dr. Gay said.

Dr. Gay contacted Dr. Katherine Luzuriaga, an immunologist at the University of Massachusetts, who was working with Dr. Persaud and others on a project to document possible pediatric cures. The researchers, sponsored by amfAR, the Foundation for AIDS Research, put the baby through a battery of sophisticated tests. They found tiny amounts of some viral genetic material but no virus able to replicate, even lying dormant in so-called reservoirs in the body.

There have been scattered cases reported in the past, including one in The New England Journal of Medicine in 1995, of babies clearing the virus, even without treatment.

Those reports were greeted skeptically, particularly since testing methods were not very sophisticated back then. But those reports and this new one could suggest there is something different about babies’ immune systems, said Dr. Joseph McCune of the University of California, San Francisco.

One hypothesis is that the drugs killed off the virus before it could establish a hidden reservoir in the baby. One reason people cannot be cured now is that the virus hides in a dormant state, out of reach of existing drugs. When drug therapy is stopped, the virus can emerge from hiding.

“That goes along with the concept that, if you treat before the virus has had an opportunity to establish a large reservoir and before it can destroy the immune system, there’s a chance you can withdraw therapy and have no virus,’’ said Dr. Anthony S. Fauci, the director of the National Institute for Allergy and Infectious Diseases. Adults, however, typically do not know they are infected right as it happens, he said.

Dr. Steven Deeks, professor of medicine at the University of California, San Francisco, said if the reservoir never established itself, then he would not call it a true cure, though this was somewhat a matter of semantics. “Was there enough time for a latent reservoir, the true barrier to cure, to establish itself?’’ he said.

Still, he and others said, the results could lead to a new protocol for quickly testing and treating infants.

In the United States, transmission from mother to child is rare – several experts said there are only about 200 cases a year or even fewer, because infected mothers are generally treated during their pregnancies.

If the mother has been treated during pregnancy, babies are typically given six weeks of prophylactic treatment with one drug, AZT, while being tested for infection. In cases like the Mississippi one, where the mother was not treated during pregnancy, standards have been changing, but typically two drugs are used.

But women in many developing countries are less likely to be treated during pregnancy. And in South Africa and other African countries that lack sophisticated testing, babies born to infected mothers are often not tested until after six weeks, said Dr. Yvonne Bryson, chief of global pediatric infectious disease at the University of California, Los Angeles.

Dr. Bryson, who was not involved in the Mississippi work, said she was certain the baby had been infected and called the finding “one of the most exciting things I’ve heard in a long time.’’

Studies are being planned to see if early testing and aggressive treatment can work for other babies. While the bone marrow transplant that cured Timothy Brown is an arduous and life-threatening procedure, the Mississippi treatment is not and could become a new standard of care.

While it might be difficult for some poorer countries to implement, treating for only a year or two would be cost effective, “sparing the kid a lifetime of antiretroviral therapy,’’ said Rowena Johnston, director of research at amfAR.

Pasted from <http://www.nytimes.com/2013/03/04/health/for-first-time-baby-cured-of-hiv-doctors-say.html?pagewanted=all&_r=0>

NEW YORK CITY — Lara Licharowicz has seen it every January — a surge of instant fitness fiends flooding the gyms around the city with high hopes of achieving their New Year’s resolutions.

“You couldn’t get a treadmill it gets so crowded,” Licharowicz said of the Upper East Side’s Sports Club LA, where she used to work. “Then you start to see it trickle down and you’re back to normal by mid-February.”

Most overnight health nuts may abandon their goals within a month or two after setting resolutions in January, but the crash is not inevitable, experts say. All it takes is patience, focus and a few easy tricks to stay on track to make sure your fitness resolution is a lifelong marathon, not a sprint.

Tip No. 1: Invest in High-Quality Workout Clothes

Before his clients kick off their new workout programs, trainer Manuel Clemente tells them to go shopping.

“Go buy the most expensive workout clothes,” he advised, “because if you’re a person like I am you don’t like to waste money. You don’t want to see $300 pair of Nikes sitting in the closet collecting dust.”

Not only will you feel obliged to get wear out of your new threads, but a new outfit will help you “look the part” to be motivated, he said.

Plus, it might stop you from splurging on unhealthy indulgences, added Clemente, a trainer at Body Space Fitness on West 14th Street in Manhattan.

“You may not want to spend as much money on alcohol or going out,” he said.

Tip No. 2: Ignore the “No Pain No Gain” Philosophy

Whether starting with brief exercises or mildly strenuous activities, Licharowicz and other trainers insisted that a “microprogression” is the only reliable way to work up to your optimal shape without giving up prematurely.

“I’m very, very opposed to the idea of no pain no gain,” said Licharowicz, who now owns her own fitness studio, The Lara Touch. “You want to work out to a threshold where you don’t feel really sore afterwards… you want to finish a workout invigorated, not exhausted.”

Licharowicz added that the key is “small but consistent steps.”

Fellow trainer Sheryl Dluginski of Generations Fitness studio takes the same approach.

“Even just the littlest bit…seven days a week is more powerful and meaningful than trying a new class two days a week,” Dluginski said, claiming that taking daily time to focus on exercise or meditation can transform a person’s health. “Once you have your foot in the door you can open it more and more.”

Tip No. 3: Start With Your Core

Longtime Miami trainer Dane Evans, who now lives in Williamsburg, agreed that small, consistent steps are key — but he emphasized that full body fitness starts with your stomach and chest, even when it comes to weight-lifting.

“Start off doing 15 minutes of core work two or three days a week for a few weeks…just Google the words ‘core exercises,’” he said of how to make a simple beginning.

Then head to the gym for full body workouts, he instructed, which would employ the stomach’s strength to lift weights properly rather than straining other muscles.

Tip No. 4: Focus on Repetition and Multiple Muscle Groups

Evans said the best way to build muscles was through multiple sets of lifting lighter weights, and noted that every workout, besides the initial core exercises, should last about 30 to 40 minutes and focus on the entire body.

“You don’t want to go in and work out one muscle and then not go back for a few weeks,” he warned. “I don’t work out with crazy heavy weights. I work out with moderate weights with repetition and that keeps my body maintained.”

Tip No. 5: Embrace the Power of Other People

The beauty of the new year, Licharowicz said, is that almost everyone is united in the feeling that they are turning over a new leaf.

“The emotional benefit of starting in January is that everyone is starting off together,” she said, adding that “your sins of the last year of not working out are forgiven.”

And the people who continue their workouts past January, she claimed, are the ones who find another person to track their progress.

“Make a partnership with a friend or a personal trainer,” she said.

Tip No. 6: Jam Out

To avoid distractions, to energize and to focus on your own experience, Clemente suggests wearing headphones on every visit to the gym.

“You have to have headphones,” he said. “Every gym is going to get crowded, but you have to zone out, be in yourself and get into a happy place.”

Tip No. 7: Imagine You Have Already Achieved Your Goal

If weight loss or changing your body is your focus, Licharowicz said, you can easily fall into the trap of discouragement over the person you wish you were.

“Say, ‘I wonder what it would feel like it I were 10 pounds skinnier,’” she instructed. “And if you’re thinking [if] you’re skinny you’re going to make a healthier choice…See yourself as if you’ve already achieved the goals and live into being that person.”

Tip No. 8: Do What You Love

Whether you prefer dancing, basketball or martial arts, follow your passion to keep up your workout routine.

“When choosing a form of exercise it’s really important that it be fun and light you up in some way,” Licharowicz said, “because if it feels like a chore you won’t keep it up.”

Read more: http://www.dnainfo.com/new-york/20130108/williamsburg/how-avoid-workout-burnout-along-with-your-new-years-resolution#ixzz2K6ZBrXGU

Openings & Closings

Each week, DNAinfo rounds up the restaurants and small businesses that open and close in your neighborhood.

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QUEENS — A long-awaited Chipotle restaurant has finally opened on Austin Street, drawing hundreds of customers since its opening earlier this week.

On Wednesday, Jan. 30, when the restaurant at 70-30 Austin St., opened for the first time, it served customers at a rate of about 120 people an hour, said general manager, Hank Zhang. “We had a line (stretching from the counter) to the doors from 11:30 in the morning till closing,” he said. The restaurant is open daily from 11 a.m. to 10 p.m.

Local residents and workers said it’s a welcome addition to the neighborhood.

“I was passing by almost every day to check when they are going to open,” said Alex Banks, 17, a Middle Village resident, who works in the area as an after-school program counselor. “It’s really good,” added Banks, who ordered a chicken burrito.

“We’ve been waiting for it for a long time,” said Janet Alva, 34, a Forest Hills resident who works for the aviation industry and came to Chipotle for lunch on early Tuesday afternoon.

There are also two gastropubs coming to the area.

Forest Hills Station House at 106-11 71st Ave. is slated to open before St. Patrick’s Day. One of the owners, Drew Dvorkin, said the venue would be a craft beer bar, offering “a new level of beer and food that Forest Hills hasn’t seen before.”

Dvorkin also said he is planning to serve a lot of local and regional craft beers as well as whiskeys and bourbons.

Another gastropub is under construction at 70-28 Austin St., where a Johnny Rockets restaurant was located. “It will be an Irish gastropub,” said the owner, Declan Morrison, who also owns Blackwater Inn on Metropolitan Avenue in Forest Hills.

He said the new pub, called “The Flying Pig,” will focus on serving local products and craft beers. Morrison said he hopes to have it open around mid April.

Kung Fu Tea, a tea house, is also coming to 70-10 Austin St. A hand painted sign in the window says “Opening soon,” although no firm date has been set.

Read more: http://www.dnainfo.com/new-york/20130131/forest-hills/first-chipotle-queens-draws-hungry-crowds-austin-street#ixzz2K6YaJZ5f

FDA approves pill to prevent the HIV virus so tell me people how long do you think they had this pill makes you wonder doesn’t it well here is a theory i think the hood needs to know i think back in those government refrigerators they have had the cure all along.I think the cure for of these man made diseases are given too only the people who have bank accounts as long as train smoke im not saying they put these viruses out to kill off the minorities but i do think they do it to minimize our numbers because in all actualities we are the majority meaning latinos and african americans.lets take a quick look at this over ten years ago magic johnson from the L.a Lakers was diagnosed with the HIV virus now in 2012 its not even detected in his blood go figure in those times magic was like the babe ruth of basketball his money was long so he can afford that cure let that have been miguel so an so from D.r and he would have died year 2 on us.So we are here to update you on all you need to know on what they really don’t tell us for the hood by the hood more on this topic soon here at  www.thehoodneedstoknow.com