A doctor has challenged reports of a baby in Mississippi being “cured” of HIV.
In an opinion piece for the Wall Street Journal, Mark Siedner points out the news of the “cure” spread throughout the globe ahead of the actual presentation of results at the annual HIV conference in Atlanta.
The original news described the case of a child born with the virus that causes Aids, who is now two-and-a-half, and has been off medication for about a year, with no signs of infection.
The child’s mother had had no prenatal care and only discovered she had the virus while in labour.
Usually doctors give the newborn low doses of medication to prevent HIV from taking root, but the rural hospital did not have the liquid available.
Instead this baby was given a cocktail of three drugs already used to treat HIV within 30 hours of its birth.
The individual was lauded as now being “functionally cured”, meaning it is in long-term remission even though there is no guarantee all traces of the virus have disappeared.
But Dr Siedner, who is a postdoctoral fellow in the division of infectious diseases at Massachusetts General Hospital and Harvard Medical School, points out exposure to HIV does not necessarily mean infection.
He wrote:
There has only been one other case of a reported cure, when a patient was given a bone marrow transplant from a donor who had a genetic resistance to the virus.
Two million people die of Aids every year. HIV is estimated to have infected 33 million people worldwide.
Initial reports after the announcement quoted Dr Deborah Persaud, a virologist at Johns Hopkins University in Baltimore, telling the conference: "This is a proof of concept that HIV can be potentially curable in infants.”
"You could call this about as close to a cure, if not a cure, that we've seen," Dr. Anthony Fauci of the National Institutes of Health told The Associated Press.
Dr Hannah Gay, a pediatric HIV specialist at the University of Mississippi, said in an interview: "I just felt like this baby was at higher-than-normal risk, and deserved our best shot.”
Dr. Hannah Gay, a pediatric HIV specialist at the University of Mississippi
Stressing prevention is always better than cure, Dr Gay added: "We can't promise to cure babies who are infected. We can promise to prevent the vast majority of transmissions if the moms are tested during every pregnancy."
But as Dr Seidner writes, the case might not be the breakthrough everyone hoped for because "we will likely never know if those cells were from the child or maternal cells that had been transmitted during pregnancy or birth."
Genevieve Edwards, Director of Health Improvement at Terrence Higgins Trust, said: "In the UK we already have a programme of ante-natal screening for HIV, which means that there are very few babies born with the virus.
“Expectant mothers with HIV are given anti-HIV treatment during pregnancy which together with a low-risk caesarean and no breastfeeding means their babies have a 98% chance of being HIV negative. But this could be of interest where mothers to be are diagnosed with HIV during labour rather than pregnancy.
"The roll-out of anti-retroviral therapy across the developing world has both saved the lives of individuals living with HIV, and also had a real impact on the rates of mother-to-child transmission. In this context, it would seem that success lies in making antenatal testing available and then giving the drugs to the mother to prevent the child getting HIV, rather than hoping the drugs will cure the baby once born HIV positive. But for those babies born with the virus, this may be significant.”