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N Engl J Med. 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.

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From the Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore (D.P., C.Z., Y.H.C.), Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick (M.P.), and the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda (T.-W.C.) - all in Maryland; the Department of Pediatrics, University of Mississippi Medical Center, Jackson (H.G.); the University of California San Diego, La Jolla, and the Veterans Affairs San Diego Healthcare System, San Diego (M.S., D.R.); and the Department of Pediatrics, Program in Molecular Medicine, and Center for Clinical and Translational Science, University of Massachusetts Medical School, Worcester (K.L.).


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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