Mississippi HIV/AIDS advocates are meeting the news of a baby's apparent cure from human immunodeficiency virus with hope and cautious optimism. Scientists announced over the weekend that a Mississippi baby born with HIV more than two years ago and who has not received treatment for about a year appears to be cured.
The breakthrough came when Dr. Hannah Gay, a pediatric HIV specialist at University of Mississippi Medical Center, gave the baby faster and stronger treatment than is usual, starting a three-drug infusion within 30 hours of birth. That was before tests confirmed the infant was infected--rather than just at risk from a mother whose HIV wasn't diagnosed until she was in labor.
"I just felt like this baby was at higher-than-normal risk, and deserved our best shot," Gay told the Associated Press.
That fast action apparently knocked out the HIV virus in the baby's blood before it could form hideouts in the body. Those so-called reservoirs of dormant cells usually rapidly reinfect anyone who stops medication, said Dr. Deborah Persaud of Johns Hopkins Children's Center to the AP. She led the investigation that deemed the child "functionally cured," meaning in long-term remission even if all traces of the virus haven't been completely eradicated.
Valencia Robinson, executive director of Mississippi in Action, an HIV/AIDS nonprofit, has mixed feelings about the news.
"I think it's wonderful because the South has some of the worst HIV numbers. I also have this fear that with people hearing that there's a cure, infection rates could go up," said Robinson, who talked to an individual over the weekend who thought the scientific breakthrough means no longer having to practice safe sex.
Robinson said HIV/AIDS educators might have to redouble outreach efforts to educate people that just because Gay's treatment worked on an infant, that doesn't necessarily translate into treating adults who have higher levels of HIV in their bloodstreams.
Robinson also worries that policymakers could misinterpret the findings and pull funding from HIV/AIDS research--a troubling thought in Mississippi, which has the nation's third-highest rate of AIDS cases in the nation. In total, southern states represent the top three states for AIDS rates. Among cities, Baton Rouge, La., and Miami rank first and second for AIDS infections.
Besides, there's no guarantee the Mississippi child will remain healthy, although sophisticated testing uncovered just traces of the virus' genetic material still lingering. If it does, it would mark only the world's second reported HIV cure.
About 300,000 children were born with HIV in 2011, mostly in poor countries where only about 60 percent of infected pregnant women get treatment that can keep them from passing the virus to their babies. In the U.S., such births are very rare because HIV testing and treatment have long been part of prenatal care.
"We can't promise to cure babies who are infected. We can promise to prevent the vast majority of transmissions if the moms are tested during every pregnancy," Gay told the AP.
The only other person considered cured of the AIDS virus underwent a very different and risky kind of treatment--a bone marrow transplant from a special donor, one of the rare people who is naturally resistant to HIV. Timothy Ray Brown of San Francisco has not needed HIV medications in the five years since that transplant.
The Mississippi case shows "there may be different cures for different populations of HIV-infected people," said Dr. Rowena Johnston of amFAR, the Foundation for AIDS Research. That group funded Persaud's team to explore possible cases of pediatric cures.
It also suggests that scientists should look back at other children who've been treated since shortly after birth, including some reports of possible cures in the late 1990s that were dismissed at the time, said Dr. Steven Deeks of the University of California, San Francisco, who also has seen the findings.
"This will likely inspire the field, make people more optimistic that this is possible," he said to the AP.
In the Mississippi case, the mother had received no prenatal care when she came to a rural emergency room in advanced labor. A rapid test detected HIV. In such cases, doctors typically give the newborn low-dose medication in hopes of preventing HIV from taking root. But the small hospital didn't have the proper liquid variety, and sent the infant to Gay's medical center. She gave the baby higher treatment-level doses.
The child responded well through age 18 months, when the family temporarily quit returning and stopped followup treatment, researchers said. When they returned several months later, remarkably, Gay's standard tests detected no virus in the child's blood.
Ten months after treatment stopped, a battery of super-sensitive tests at half-a-dozen laboratories found no sign of the virus' return. Only some remnants of genetic material that don't appear able to replicate remain, Persaud said.
In Mississippi, Gay gives the child a check-up every few months; "I just check for the virus and keep praying that it stays gone," she said.
The mother's HIV is being controlled with medication and she is "quite excited for her child," Gay added.
The Associated Press contributed to this report.