Doctors had hoped that swift and aggressive anti-retroviral treatment might eradicate HIV in babies born with the infection

Doctors in Italy have reported that a baby who was apparently cleared of HIV after an early and intensive course of antiviral drugs is still infected with the virus three years later.

The finding is another blow for HIV scientists who hoped that swift and aggressive treatment with anti-retroviral therapy might eradicate the virus in babies who are born with the infection.

Medics in Milan gave anti-retroviral drugs to the baby boy within 12 hours of his birth in December 2009. At the age of three, the boy tested negative for the virus and his treatment was stopped with the agreement of his mother, a drug user had not been aware that she was HIV-positive when she went into labour.

But writing in The Lancet on Friday, the Italian doctors report that despite the virus being undetectable in the boy’s bloodstream for three years, the infection became apparent again only two weeks after they stopped treatment.

The recurrence suggests that while drug therapy had depleted the virus and confined it to remote corners of the boy’s body, it bounced back as soon as the anti-retroviral therapy was stopped.

The case comes after doctors in Mississippi this year reported a similar return of HIV in a baby girl who was born with the virus but tested negative after an early and aggressive course of anti-retroviral treatment.

Professor Mario Clerici, a doctor on the team at the University of Milan and the Don Gnocchi Foundation, said that despite HIV returning in the boy, there were no other options for doctors faced with a baby who is born HIV positive apart from swift and intensive anti-retroviral therapy.

“We cannot achieve a cure of HIV, so we should try and contain the disease, and the only way we can do that is with this therapy,” he said.

The only patient who seems to have been cured of HIV is Timothy Brown, known as “the Berlin patient”, who has been clear of the virus since 2008 when he received a bone marrow transplant from a donor with natural immunity to HIV. Doctors are now running clinical trials to investigate whether immune cells modified to carry natural resistance can be infused into patients to treat HIV infection.

“Although there are a large number of antiviral medications to control HIV, a cure hasn’t been found,” said Sanjaya Senanayake, an infectious diseases physician at the Australian National University Medical School in Canberra.

“At the time of stopping the antiviral medicines, the child’s immune system was still responding as if HIV was present even though the virus was undetectable. And within two weeks of stopping treatment, the virus became detectable again,” he said.

“This case shows that undetectable HIV in the blood does not mean that the body is free from virus and that there is still some way to go before a cure is found.”