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Nature Names Johns Hopkins Pediatric HIV Expert Deborah Persaud One of 10 People Who Mattered in 2013 - 12/23/2013

Nature Names Johns Hopkins Pediatric HIV Expert Deborah Persaud One of 10 People Who Mattered in 2013

Release Date: December 23, 2013

The science journal Nature has named Johns Hopkins Children's Center physician Deborah Persaud, M.D., one of this year's 10 people who mattered for her work in providing "the strongest evidence yet that infants born with HIV can be cured," say the journal's editors.

Others who made this year's list include a biologist, an anthropologist, an anti-gene-patent advocate, an astronomer and a Filipino diplomat crusading against climate change.

Persaud is being recognized for her work on the so-called "Mississippi baby" case, which gained mainstream attention in March after Persaud and colleagues Hanna Gay, M.D., of the University of Mississippi Medical Center, and Katherine Luzuriaga, M.D., of the University of Massachusetts Medical School, announced that a baby born with HIV was free of infection despite being off treatment for nearly a year. Persaud and colleagues said the child had gone into remission after receiving aggressive, high-dose therapy within hours of birth. Doing so appears to have quashed the formation of viral hideouts known to form very early during infection and to preclude viral clearance down the road.

The announcement generated hope that HIV could one day soon be curable, but also raised some important questions about the case. A follow-up, detailed report of the case published Oct. 23 in The New England Journal of Medicine dispelled any lingering doubts that this might have been a mere fluke and confirmed that the child remains free of active infection despite being off treatment for more than18 months, becoming the first documented case of HIV remission in a child.

Persaud and colleagues see the case as a game-changer supporting the notion that very early treatment can prevent the virus from taking a hold in immune cells, tissues and organs where it can lie dormant for years while patients receive treatment, but emerges from hiding and reignites a full-blown infection once antiviral therapy is stopped. HIV's ability to set up such persistent reservoirs shortly after infection is one of its most troublesome behaviors, and it is the one that has thus far precluded a true cure. The Mississippi case suggests a pathway to one.

The case became a catalyst for a host of new studies, including a federally funded trial slated to begin early next year. Researchers hope to determine whether the Mississippi approach could work in all HIV-infected newborns. Achieving such long-term remission in all newly infected babies could spare millions of children from lifelong drug treatment, Persaud and colleagues say.

"Debbie Persaud's latest research has reignited the interest in finding a cure for a disease that many had given up on as incurable," says Johns Hopkins Children's Center Director George Dover, M.D. "But beyond that, her work has left an indelible fingerprint on the field of pediatric HIV by illuminating some of HIV's most mysterious and worrisome behaviors."

A virologist and an infectious disease specialist, Persaud has dedicated her life's work to understanding the behavior of the virus that causes AIDS and to applying this knowledge to helping children affected by it. As a pediatrician-in-training in New York City in the 1980s, Persaud witnessed the devastation caused by the virus during the early days of the epidemic. She saw many HIV-infected babies and children succumb to AIDS, a harrowing experience that compelled her to study this formidable foe. Over the last 20 years, medicine has made great strides against HIV and AIDS. Despite the remarkable advances that have occurred since the 1980s, today 3.3 million children worldwide continue to live with HIV and nearly 260,000 are infected at birth each year. Persaud is on a mission to change this grim picture, and insights gleaned from her recent and ongoing work promise to do just that. 

Persaud grew up in Guyana and came to the United States as a teenager. She received her medical degree from the New York University School of Medicine and completed a residency at Babies & Children's Hospital at Columbia-Presbyterian Medical Center in New York, where she also served as chief resident. Persaud completed her fellowship at the New York University School of Medicine. She is the scientific chair of the HIV CURE Scientific Committee of the International Maternal, Pediatric Adolescent AIDS Clinical Trials (IMPAACT) group, a consortium of researchers and institutions that was critical in leading the earliest clinical trials of mother-to-child transmission and early treatment of infants 15 years ago.

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