The authors describe a case of functional HIV cure in a 26-month-old child, perinatally infected with HIV subtype B who was given
antiretroviral therapy (ART) at 30 hours of age. Infant’s HIV infection was confirmed by positive HIV DNA and RNA testing on 2 separate blood samples obtained on the 2nd day of life. HIV viral load on day 7, 12, and 20 of life were also positive. HIV viral load became undetectable on Day 29 of life. HIV viral load subsequently remained undetectable even at 26 months of age inspite of ART discontinuation 18 months of age. Using ultrasensitive methods, a single copy of HIV RNA was detected in plasma at age 24 months and 37 copies HIV DNA/million peripheral blood mononuclear cells (PBMC) enriched for monocytes were detected. Replication-competent virus was not detected following co-culture of 22 million purified resting CD4+ T cells. At age 26 months HIV DNA was detected at 4 copies/million PBMC but with no 2-LTR circles. Plasma viral load, PBMC DNA, and HIV-specific antibodies remained undetectable with standard clinical assays.