In a case that could have dramatic global implications, scientists announced yesterday in Atlanta that they had cured a little girl born with HIV—the first child in the world known to have been cured of the infection.
She was born in Mississippi and is now 2 ½ years old—and free of the disease, according to scientists who presented their case at a scientific conference in Atlanta.
Because American doctors over the past 15 years have been treating virtually all pregnant women infected with HIV with antiretroviral drugs during pregnancy and labor, mother-to-child HIV transmission in the U.S. is extremely rare, with fewer than 200 cases a year. But the story is much different overseas. There are an estimated 330,000 children around the world who get infected with HIV at or around birth every year—most of them in sub-Saharan Africa. Until now, doctors thought the only way to keep those children alive was to give them costly lifelong antiviral drugs.
But this new Mississippi cure is “definitely a game-changer,” according to Dr. Deborah Persaud of Johns Hopkins University Medical School, who presented the case at the Congress on Retroviruses and Opportunistic Infections.
“This case is sort of the inspiration and provides the rationale to really move forward,” Persaud said.
But there was also skepticism in the scientific community—as there almost always is.
“It’s a hypothesis-generating case,” Anthony S. Fauci, head of the National Institute of Allergy and Infectious Diseases, told the Washington Post. “It will give us some food for thought about studies that need to be done to see if this is a real phenomenon.”
A University of Mississippi pediatric infectious disease specialist named Hannah Gay is credited with the quick thinking that led to the initiation of treatment of the Mississippi newborn.
“The child came to our attention as a high-risk exposure to maternal HIV,” Gay said. Because her mother hadn’t had any prenatal care, the baby didn’t get antiviral drugs during pregnancy.
Gay decided to begin treating the child immediately, with the first dose of antivirals given within 31 hours of birth, which is faster than most infants born with HIV get treated.
Gay also gave higher-than-usual “therapeutic” doses of three powerful HIV drugs rather than the smaller doses usually given in these circumstances.
Over the months, the baby thrived and standard tests could detect no virus in her blood, which is the normal result from antiviral treatment.
“The baby’s mom was having some life changes, that’s about all I can say,” Gay said. “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.”
After enlisting the help of Mississippi state health authorities, Gay was able to find the child—whose mother told them she’d stopped giving antiviral drugs six or seven months earlier.
At that point, Gay expected to find that the child’s blood was teeming with HIV, but that wasn’t the case at all. To her astonishment, tests couldn’t find any virus.
“It’s exciting to us,” said Dr. Katherine Luzuriaga at the University of Massachusetts, who has been studying pediatric HIV/AIDS for two decades and who assisted Gay, “because if we were able to replicate this, I think it would be very good news.”
