Groundbreaking news in the field of AIDS research and in health science in general: scientists believe a little girl born with HIV has been cured of the infection. She’s only the second person in the world—and the first child—to be cured since the virus caused a global pandemic more than three decades ago. At the Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta this past Sunday, scientists presented details of the case. Though the child’s name has not been released, the following information has been confirmed: she was born in Mississippi, she is now two and half years old, and most importantly, she remains healthy.
The implications of the cure are widespread, from an individual standpoint all the way to global. A single child has been saved in America, and that’s hugely significant in the field of medicine; the best possible outcome. What’s more, an estimated 330,000 children around the world are infected with HIV every year—in birth or near that time—most cases in sub-Saharan Africa, and this can mean the difference between life and death for that population. While fewer than 130 children are born with HIV each year in the U.S., HIV is causing a continent-wide genocide of children in other parts of the world.
Up to this point, babies born with HIV were considered permanently infected. That means a lifelong dependence to antiviral drugs, or the alternative: the slow and painful destruction of their immune systems. The cure of the little girl from Mississippi happened by accident, due to the quick, risky move made by University of Mississippi pediatric infectious disease specialist, Hannah Gay.
According to Gay, the mother of the child didn’t receive any prenatal care, meaning no antiviral drugs during pregnancy. “The child came to our attention as a high-risk exposure to maternal HIV," Gay reports. Because the newborn tested positive for the disease within the first thirty hours of her life, specialists assumed she was infected in utero. Gay made a quick, life-altering decision: to treat the child immediately—within an hour of diagnosis—with the first dose of antivirals. Most infants born with HIV are not treated so quickly, and specialists believe that’s one of the reasons for the child’s cure. Another thing: Gay gave three different “therapeutic” doses of powerful HIV drugs, much higher than usual, rather than the typical “prophylactic” doses used in similar circumstances. In the next months, during careful observation, the baby's blood tested virus free. Though this often occurs as a result of antiviral treatment, Gay was still optimistic.
Unfortunately, “the baby’s mom was having some life changes,” says Gay, and she stopped bringing the child in for checkups. “I saw her at 18 months, and then after that did not see her for several months. And we were unable to locate her for a while.”
Gay finally enlisted the help of Mississippi state health authorities to track down the child. When they found the child, they were told by the mother that she hadn’t kept up with the recommended dosage of antiviral drugs, and the child hadn’t received any medication for six or seven months. Gay expected to find large amounts of HIV in the child’s blood, but when the tests came back, the results were astonishing: no detection of the virus.
At first, Gay wondered if she’d made a mistake. “My first thought was, ‘I’ve been treating a child who’s not actually infected,’ ” she said. After double-checking the original blood tests, they confirmed the child had been infected with the virus at birth. She ran the tests again, to make sure the lab hadn’t made a mistake. Again and again, the blood was virus-free.
Make no mistake about it: this cure will dramatically change the way babies born with HIV are treated, and more importantly, it will forever change the global impact of the disease as we know it.
