On Sunday, doctors announced that after giving a baby born with HIV an aggressive regimen of drugs shortly after her birth in Mississippi, two and a half years later she is “functionally cured” of the disease. The discovery could have huge implications for the treatment and testing of babies born with the disease, particularly in developing countries. Incredibly, doctors were only trying to treat the girl’s disease, and stumbled on the cure due to a series of accidents.
In the U.S., doctors can usually prevent transmission from an infected mother to her baby through prenatal treatments, but in this case the mother didn’t know she had HIV until she showed up at the hospital in labor. Since the rural hospital didn’t have a medication that can prevent HIV from from taking root in newborns, the child was transferred to the University of Mississippi Medical Center. There, Dr. Hannah Gay gave the girl faster and stronger treatment than usual, starting her on three anti-retroviral drugs at 30 hours old. “I just felt like this baby was at higher-than-normal risk, and deserved our best shot,” Dr. Gay, a pediatric HIV specialist, told the Washington Post.
As expected, the girl’s virus levels quickly dropped and doctors continued giving her the standard treatment for babies with HIV for the next 18 months. Then her mother stopped bringing her in, and when she returned she said she hadn’t given the girl her medication for at least five months. Dr. Gay expected to find that the virus had started replicating again, but tests showed the girl was HIV negative. At first, Dr. Gay worried that she had been treating an uninfected child, but five tests shortly after the girl’s birth had come back positive. Further testing found small amounts of viral genetic material, but no virus that could replicate. Doctors believe that due to Dr. Gay’s quick action, the HIV was knocked out of the girl’s blood before it could form reservoirs of dormant cells, which usually reinfect patients who stop taking medication.
The girl is the second person who doctors believe has been cured of HIV. The first was Timothy Brown, who received a bone marrow transplant in 2007 from a donor who has a rare condition that makes them resistant to the disease. That procedure is too difficult to be used as a cure for many people with HIV, and the new discovery wouldn’t help adults with the disease either. However, the girl’s case could lead to a major shift in the treatment of pediatric HIV. In 2011, 330,000 children were infected with HIV, mainly in poor countries where many women don’t have access to prenatal care. If further studies find that the results can be replicated, it might be possible to wipe out the disease in infancy, rather than requiring a lifetime of treatment.