News outlets all over the world have reported about the astonishing news that a baby girl in Mississippi was cured of the HIV virus, contracted from her mother at birth.
While the facts certainly make for incredible headlines, medical experts, including the doctor that treated this patient, warn against believing that this is the breakthrough case of the year.
The baby who created this uproar was born two years ago in a rural Mississippi hospital. According to the Associated Press, her mother, whose identify is being kept confidential for privacy reasons, found out she was HIV positive during labor.
Since she was not aware of her HIV status, she did not take the typically administered transmission-reducing drugs. These drugs have helped to reduce the rate of mother-to-child HIV transmission to just 1 percent. Without these drugs the rate of transmission is 20-25 percent.
Knowing that the baby girl was at such high risk for contracting HIV, the pediatric HIV specialist at the University of Mississippi Medical Center where she was transferred decided to try an aggressive drug therapy.
Dr. Hannah Gay administered antiretroviral drugs to the infant when she was only 30 hours old. The standard of care is to wait until at least six weeks after birth to confirm that the HIV antibodies are actually in the baby, and not just passed on passively from the mother.
Gay believed the baby's risk to be so high that she did not even wait the several days it would take to get the test results saying whether the child was HIV positive or negative. She felt it necessary to start treating the baby as if she had the HIV virus.
In a press conference reported by ABCNews, Dr. Gay defended her bold choice by saying, "When we consider starting any medication in any patient, we always consider the risk-benefit ratio. When the risk is something as serious as HIV disease, then it's worth the benefit that you may get from preventing that disease. Even though you never want to start drugs that may cause toxicities, if the benefit outweighs the risk, you do it."
The baby continued taking a three-drug regimen for the next 18 months until the baby's mother abruptly stopped taking her to appointments, stopping treatment.
When the child resumed treatment five months later, doctors expected her to have high viral loads but to the contrary, she had no active HIV infection. After more sensitive testing and five more months, the now two-and-a-half-year-old is virtually virus and symptom free. Doctors call it a "functional cure".
Some experts say reporting this case as a "cure" has been a disservice, giving false hope to parents of HIV-infected babies and others infected with the disease, and making medical professionals question the typical standard of care in these situations.
Skeptics surmise that the drugs prevented the infection from gaining hold and thus she was never infected in the first place and therefore never "cured".
But the reality is that there could be extenuating factors that caused this baby's virus to remain dormant and that she could experience symptoms in the future.
The bottom line is there needs to be many more replications of this therapy with the same result to effectively call it a cure, though this is a positive step in the right direction.
Sources:
ABCNews.com. Web. Published 6 March 2013. "HIV 'cure': Is it real? Is it safe?"
http://abcnews.go.com/Health/hiv-cure-real-safe/story?id=18659089
WSJ.com. Web. Published 11 March 2013. "Mark Seidner: About that baby who was 'cured' of HIV".
http://online.wsj.com/article/SB10001424127887323826704578352723050205196.html?mod=googlenews_wsj
Reviewed March 14, 2013
by Michele Blacksberg RN
Edited by Jody Smith