A two-year-old girl from Mississippi is now the second person to be declared “functionally cured” of HIV. The child, who contracted HIV from her mother during birth, received treatment for the first 15 months of her life. When she was 18 months old, doctors lost contact with the child. When her mother brought her back to resume treatment five months later, doctors were astonished to find that the 23-month-old HIV patient tested negative for the virus.
Dr. Hannah Gay, the pediatric HIV specialist who had been treating the girl, told ABC News, “My first thought was to panic. I thought, ‘Oh my goodness, I have been treating a child who is not actually infected.’”
A number of hyper-sensitive tests detected traces of unviable HIV fragments in the girl’s blood. These fragments aren’t capable of replicating, meaning that the girl is no longer infected with HIV. While it’s possible the girl wasn’t infected with HIV in the first place, experts like Dr. Anthony Fauci of the National Institute for Allergies and Infectious Diseases think that’s unlikely. The only way that traces of the virus could be found in the baby’s blood now is if she’d been infected to begin with.
How did this happen? Dr. Hannah Gay, who treated the newborn for HIV at the University of Mississippi Medical Center in Jackson, chose an unconventional treatment. In the U.S., most babies born to HIV-positive mothers don’t contract the virus, due to pre- and post-natal preventative care. This mother, however, didn’t know she had HIV. By the time doctors discovered her status, it was already too late to begin the standard preventative measures.
Instead of giving the baby just one antiretroviral drug, as is standard in this situation, Dr. Gay chose to administer three: 3TC, AZT and nevirapine. These drugs are prescribed for long-term HIV management in babies. Dr. Gay administered the first dose when the Mississippi baby was a mere 30 hours old.
Doctors think that administering this powerful combination of drugs so early after infection may have knocked out the virus completely. The drugs may have killed the HIV virus in the baby’s bloodstream before it could infect her immune system’s CD4 cells, and create the viral reservoir that makes HIV impossible to cure.
Researchers emphasize that this is not a general cure for HIV and could be an isolated case. Most HIV-positive infants don’t stop taking their drugs, and it’s hard to tell if they’ve been cured without stopping their treatment and testing their viral load a few months later. Doctors hesitate to do this.
Less than 200 HIV-positive babies are born in the U.S. each year, but hundreds of thousands of Third World children are born with the disease annually. Most die before their first birthday. If the results of the Mississippi baby’s treatment can be replicated in clinical trials, that could change.