The medical world is celebrating over a recent case in which a baby from Mississippi has been cured of the HIV virus, a startling development that could potentially have major implications in the world of healthcare.
The child is now 2 1/2 years old and has shown no remaining signs of functional HIV infection. While the child has been off of HIV medication for over a year, doctors have waited until now to announce the success of the child’s treatment in order to be certain of the child’s HIV-negative diagnosis.
The treatment was composed of a three-drug “cocktail” that was aggressively given to the baby. The drugs used were, in fact, not newly invented and have existed for quite some time. The main innovation involved in this child’s treatment was the method used; instead of waiting and giving the baby a two-drug combination after diagnosis, the doctors preemptively started the baby with a three-drug treatment within 30 hours of his birth.
It is unclear yet, however, whether this method of treatment will function as a one-size-fits-all cure. For starters, this method worked primarily because it was implemented early enough to prevent HIV from building up within pockets of the child’s dormant cells. This method would almost certainly not work in adults or even older children, as they would already have these hidden pockets of HIV built up within the body. DePaul biology professor Sarah Connolly explains the harm of these hidden pockets.
“For adults, treatment with current antiviral drugs can reduce the HIV levels in a person down to undetectable levels,” said Connolly. “Unfortunately, when these adults are purposefully taken off of drug therapies to determine if they have been ‘cured,’ the virus rebounds.
Furthermore, it remains to be seen how widespread this method could be implemented even among infants. DePaul public health researcher Dr. Douglas Bruce has his reservations against the recent method of treatment.
“I’d caution using the word cure here,” said Bruce. “It is an interesting case study, but it hasn’t been demonstrated to be effective in more than one newborn child as of yet. It could be a kind of one-off case, or it could be something that might be replicated in other newborns.”
Regardless of whether the new method lasts through repeated trials, the concept of infant treatment comes as another step in a long line of breakthroughs in HIV treatment.
Preventive care has developed rapidly since the 1990s and is often able to prevent transmission of HIV from mother to baby, provided that the mother actively seeks out treatment after becoming pregnant. As it is, there are only a few hundred babies who are even born with HIV each year in the U.S.
“Prevention of mother-to-child transmission is one of the public health successes of the HIV era,” said Bruce. “So long as HIV-positive women access prenatal care and receive appropriate antiretroviral therapy, the chances of transmitting the HIV virus to their child are minimal.”
In addition to preventive care, there have been multiple improvements in life-prolonging medication throughout the years.
“Antiretroviral treatments have even shifted the way we think about HIV,” said DePaul professor Alexandra Murphy, who has worked with nonprofit AIDS programs in the past. “We no longer say someone is ‘dying from HIV,’ but instead, the focus is on how well they ‘live with HIV.'”
The biggest impact of infant HIV treatment may potentially lie in the developing world, where many areas still lack access to the wide array of preventive care that is available in the U.S. As a result, a large proportion of the approximately 1,000 babies born daily with HIV are from the Third World. Infant treatment would likely be alleviating for many of the areas still lacking in preventive care.
Nevertheless, treating HIV in the Third World would have its own set of challenges. In addition to the obvious economical disadvantages, Murphy describes another set of issues faced by those in such regions.
“From my experience, the challenge is getting people to know and understand their status, to get them to take action and get the medications, and to get them to stay on the medications,” said Murphy. “These challenges are more social and behavioral than medical. Long-standing social and cultural stigmas and myths surrounding those living with HIV work against people getting the help they need.”
Regardless of the social standards in the developing world, the medical community will almost undoubtedly be watching throughout the ensuing weeks and months to see whether this new method of treatment can be utilized as yet another tool in the global fight against HIV.