Research into a functional cure for HIV in neonates: the need for ethical foresight

• Published in: The Lancet infectious diseases Vol. 14; no. 9; pp. 893 - 898
• Main Authors: Shah, Seema K, JD, Persaud, Deborah, MD, Wendler, David S, PhD, Taylor, Holly A, PhD, Gay, Hannah, MD, Kruger, Mariana, PhD, Grady, Christine, PhD
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 01.09.2014; Lancet Publishing Group; Elsevier Limited
• Subjects: Acquired immune deficiency syndrome; AIDS; Antiretroviral agents; Biological and medical sciences; Biomedical Research - ethics; Disease transmission; Drug therapy; HIV; HIV Infections - drug therapy; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infant, Newborn; Infectious Disease; Infectious Disease Transmission, Vertical; Infectious diseases; Medical sciences; Neonates; Studies; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; United States > US; Mississippi; Human; Infection; Virus; Immunopathology; Newborn; Cure; Viral disease; Retroviridae; AIDS; Human immunodeficiency virus; Immune deficiency; Lentivirus
• ISSN: 1473-3099; 1474-4457
• DOI: 10.1016/S1473-3099(14)70766-2

Summary In 2013, researchers announced that a newborn child from Mississippi, USA might have been functionally cured of HIV by being given combination antiretroviral therapy within hours of birth. Public and media attention has since been captured by the possibility of finding a cure for HIV transmitted from mother to child. Research into the strategy used for the Mississippi patient is crucially important to establish whether it can be replicated and shown to work in diverse populations. At the same time, any ethical issues likely to arise in such studies should be addressed and not ignored in the pursuit of a functional cure. In this Personal View we identify ethical issues that could arise in research towards achievment of a functional cure for HIV in neonates, including difficult trade-offs associated with choosing the study population and questions about the broader social implications of the research, and propose ways to resolve them.