AJ Trager
Dr. Hanna Gay, pediatric AIDS specialist
MISSISSIPPI – Federal Officials and Medical Professionals announced that a 46-month-old Mississippi girl, thought to have been cured of HIV, has significant levels of the virus in her bloodstream.
The Mississippi Baby, born to an HIV positive mother, is now being treated for rebound viremia, elevated HIV virus levels that often occur two to four weeks after HIV infection.
Last year, doctors celebrated the case with bated breath. They hoped that the intense level of administered drugs would keep the virus away in the first cure of HIV in a child. After 27 months of not receiving anti-viral therapy, the infant has rebounded with HIV viremia.
"Certainly, this is a disappointing turn of events for this young child, the medical staff involved in the child's care, and the HIV/AIDS research community," Anthony Fauci, director of the National Institute of Allergy and Infection Diseases, said at the briefing.
Hanna Gay, M. D., a pediatric HIV specialist at the University of Mississippi Medical Center in Jackson is the child's primary care doctor. Gay said that the child would return every six to eight weeks for regularly scheduled visits to check the HIV status. Gay, along with her staff, took blood tests at every visit but didn't notice any abnormalities; there was no gradual warning. There was no evidence of enlarged lymph nodes, no enlargement of spleen or liver. Until a recent check up, the girl seemed fine. But when tests came in that showed the girl's CD4 T-cell levels at 28 percent, doctors immediately took action.
"It felt very much like a punch to the gut," Gay stated in the briefing. "It was extremely disappointing but from the scientific findings I hope it will lead to bigger and better things."
Since being administered HIV prophylactic drugs, the 46-month-old's viral levels have fallen by 75 percent of what they were when first detected.
The child's mother was diagnosed with HIV while pregnant. Within 30 hours of birth, the Mississippi baby was given a faster and stronger treatment than usual, before tests even confirmed that the child was, indeed, HIV positive.
The child underwent treatment for 18 months. After being lost to follow-up, she and her mother then came back to the University of Mississippi Medical Center, and the girl was found to have no trace of the HIV virus in the bloodstream. No anti-viral HIV treatment was administered for 27 months. This treatment set a scientific precedent, as all previous cases were off the treatment drugs for months instead of years.
Until doctors find a permanent cure, the girl will be on antiviral prophylactic therapy for the rest of her life.
"Hopefully in the next ten years we will learn how to control the virus rebound from reservoirs so treatment doesn't have to be lifelong," Professor of Infectious Diseases, Johns Hopkins Children's Center, Baltimore, Deborah Persaud said. Persaud is one of two pediatric HIV experts involved in the ongoing analysis of the young girl's case.
"The fact that this child was able to remain off antiretroviral treatment for two years and maintain quiescent virus for that length of time is unprecedented," Persaud said. "Typically, when treatment is stopped, HIV levels rebound within weeks, not years."
