Last year, a girl born with the HIV virus was declared "functionally cured" by the administration of a liquid antiretroviral almost immediately after birth. Unfortunately, the National Institutes of Health in the United States, today announced that the "Baby Mississippi" is showing detectable levels of HIV virus two years after it was taken off the medication regimen without detectable levels of virus.
The HIV virus can hide in the body
"Scientifically, this development reminds us that we still have much more to learn about the complexities of HIV infection and the virus hides in the body," said Dr. Anthony Fauci of the National Institute of Allergy and Diseases infectious told The Verge
In early July, during a routine visit clinical care of the girl, who is now almost four years old, underwent tests where he was diagnosed with the HIV virus, then other follow-up tests confirmed the sad news.
"It was very disappointing, both from the scientific point of view because we were hopeful that this would lead to bigger things, but mostly for the sake of the girl, who is now back in treatment and it seems much longer" he said at a press conference Dr. Hannah Gay, pediatric HIV specialist at the University of Mississippi Medical Center in Jackson who had treated the girl.
Despite the disappointment of the HIV virus on the girl back, doctors were quick to note that this case is quite remarkable. "The fact that this child was able to stand without antiretroviral therapy for two years and keep the virus at rest that period of time is unprecedented," said Dr. Deborah Persaud John Hopkins Children's Center in Baltimore. "Normally, when treatment is stopped, the levels of HIV bounce within weeks, not years," he added.
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It seemed a miracle, which unfortunately was not met
Born prematurely to a mother infected with HIV, "Baby Mississippi" received a cocktail of three antiretroviral drugs, 30 hours after birth. The baby remained in antiretroviral treatment for 18 months, after which the mother left to take her to the doctors and drug administration was stopped.
Five months later, doctors reexamined the girl and found that although antiretroviral treatment had stopped, his blood showed no detectable levels of HIV and HIV-specific antibodies. The details of his case were published in October in the New England Journal of Medicine as a great medical discovery.
However, during this review routine again doctors detected the virus in their blood and a drop in immune cells. After sequencing the virus, doctors determined to be identical to that had infected his mother.
Remain in treatment, but it is unique
The girl will remain subdued, but researchers are trying to understand why the HIV virus disappeared for such a long period of time without treatment, in order to extend the period of remission as long as possible. "The case of Baby Mississippi indicates that early antiretroviral treatment in this child with HIV did not completely eliminate the reservoir of HIV-infected cells that was established after infection, but may have limited its development and avoided the need for antiretroviral medication for a considerable period, "said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "We must now turn our attention to understanding why this was so, and whether the period of sustained remission in the absence of therapy may last longer."
The case had raised the possibility that children born to infected mothers can be treated aggressively with medication shortly after birth, even recommended to take antiretroviral drugs if the virus had not been detected, but there was risk. In light of this new development in the case of Mississippi, some have questioned whether it is ethical to proceed now to a clinical trial with infants as well.
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