Doctors now have compelling evidence that a newborn girl they treated aggressively for HIV infection may actually be cured. But observers say it is too soon to conclude that early therapy puts the AIDS virus into permanent remission.
She is known only as the Mississippi baby, after the southern U.S. state where the little girl was born HIV-positive, having contracted the virus in the womb of her untreated mother. Doctors placed the newborn on triple drug therapy 30 hours after birth, and continued the treatment for 18 months.
But then, doctors lost contact with her for several months, and she received no anti-AIDS medicine during that time. When she resurfaced, there was no sign of the virus in her system.
Today, at the age of three, the Mississippi baby appears to be “functionally” cured, meaning by all measures, she exhibits no sign of HIV infection. But it is still too soon to say she has been cured, according to Deborah Persaud, a pediatric AIDS specialist at Johns Hopkins University in Baltimore, Maryland.
“At this point, because the follow-up is only 18 months [from the time she reappeared], we cannot declare this child as being cured of HIV. Declaring the child cured of HIV would require a much longer follow-up period, say several years, to be able to say the virus has truly been eliminated or eradicated from the child’s body," said Persaud.
Persaud and colleagues at the University of Massachusetts wrote an article on the Mississippi baby and her progress in the New England Journal of Medicine.
In addition to being free of any apparent sign of infection, the little girl appears to have a fully functioning immune system.
The child will continue to be followed by her doctor in Mississippi, says Persaud, and will resume antiretroviral therapy if the AIDS virus reappears.
Observers are urging caution about the case. They say children who receive early, aggressive HIV treatment may not always have such a positive result. Peter Havens is head of the pediatric HIV program at Children’s Hospital of Wisconsin.
“It would be a mistake for people to just start using these drugs in children born to women with HIV hoping for a good outcome when what they could get is a lot of drug toxicity," said Havens.
Havens notes only 1 percent of children are born with the AIDS virus. So, screening for the AIDS virus in pregnant women is of key importance.
In a so-called proof-of-concept study, doctors plan to treat infected newborns with antiretroviral drugs for at least two years, watching for signs of remission before stopping treatment.