The first baby with HIV who has been cured because it “received treatment much earlier than has been customary in the past” and received “a stronger-than-usual cocktail of drugs” can affect the lives of millions not because of what is known but what is unknown.
During an interview which was published by PBS NEWSHOUR on March 3, 2013, Dr. Katherine Luzuriaga of the University of Massachusetts Medical School answered the question as to what was done differently with this HIV baby that might have contributed to its cure with the following words.
“Well, I think it was the timing of initiation. This child received three medications to prevent transmission and those three medications were continued when the child was diagnosed as infected. As a result, this baby received treatment much earlier than has been customary in the past, which we think contributed to the outcome.”
Dr. Luzuriaga is one of the researchers that confirmed that the first baby with HIV has been cured. The announcement of the historical event was made on Sunday at the 2013 Conference on Retroviruses and Opportunistic Infections in Atlanta.
What makes Dr. Luzuriaga’s interview with PBS noteworthy is that despite decades of HIV research, the cure of this one HIV baby is a symbol of how much more research has to be done and how much more there is to discover in regard to the HIV virus.
It appears that there is one common theme that follows the story of the first baby that has been cured of HIV and it is the theme of the unknown.
During her pregnancy, the mother of the HIV baby didn’t know that she had HIV and received therefore no prenatal treatment for the disease which could have prevented the transmission of HIV (human immunodeficiency virus) to the baby. When the baby was delivered, the doctors didn’t know that the mother or the baby had HIV.
It was the baby’s pediatrician, Dr. Hannah Gay of the University of Mississippi, who treated the baby with a stronger-than-usual cocktail of drugs within hours of birth because the mother was a “high-risk” HIV candidate.
“Because this baby was at risk, Dr. Gay decided to begin treatment very early and to treat the baby with three drugs. The baby had blood drawn at 30 hours and then was started on antiretrovirals without knowledge of what the baby's status was.”
After the HIV test of the baby showed that it was positive, the HIV treatment for the infant was continued during the following months. However, it is unknown how long the mother exactly provided the baby with the prescribed HIV treatment. Dr. Luzuriaga explained that the baby was treated at birth with three antiretroviral drugs and that the HIV treatment continued for anywhere between 15 to 18 months.
“There was a little bit of uncertainty there because the baby did not engage in routine care for a time and then reappeared at 23 months.”
When the HIV baby returned at 23 months, the baby’s pediatrician tested the baby again so she could get her back on her HIV treatment. She “was incredibly surprised when that first viral load came back negative. It's almost unheard of. Babies need almost constant therapy. They suppress the virus when you put them on treatment, but if you take them off, the virus comes back. And in this case, it didn't.”
“Around 18 months, the child's mother stopped treatment and follow-up visits for the baby. But five months later, the child returned to care and was found to have an ‘undetectable viral load’ -- the baby was no longer considered HIV-positive.”
By now, the former HIV baby is two and a half years old and still HIV negative and the theme of the unknown continues.
When NEWSHOUR asked Dr. Luzuriaga if the baby had low levels of the virus in her system, she answered,
“Yes, but we're not quite sure what it means. These are very low levels of virus that are around and we don't know whether these are false positives or whether they truly constitute viral load but it's just so low that it's tough to detect.”
After decades of HIV research, for most readers, it might be a surprise to find out how much scientists and researchers do not know about HIV.
The only other case known to scientists of anyone being cured of the HIV virus is the so-called “Berlin patient” who, in 2006, was “treated with a stem cell transplant from someone who was born with the genetic mutation that causes immunity to HIV infection.” Timothy Brown’s treatment would be too expensive, too complex, and too high-risk to cure the millions of people living with HIV/AIDS worldwide.
At the end of her interview with PBS, Dr. Luzuriaga mentioned that HIV research looks at both the virus as well as the person, also called the host. At this time, scientists have determined that the baby is not the kind of host who has HIV-specific immune responses or who has any other genetic type that is sometimes associated with good control of infection.
Even though HIV researchers have to distinguish between infant and adult HIV-infected individuals, this one single tiny baby has already puzzled and shaken up scientists who are now forming new hypotheses and new clinical trials; trials that might eventually affect the lives of millions. It is all it takes, -- one baby.
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