2:59pm

Thu July 10, 2014
Medical Treatments

HIV Returns In Infected Toddler, Dashing Hopes Of Imminent Cure

Originally published on Thu July 10, 2014 5:04 pm

Federal officials have announced that a young Mississippi girl, once thought to have been cured of HIV, now once again has detectable levels of the virus. This is a setback not just for the child, but also for hope of eradicating HIV in infants with a potent mix of drugs at birth.

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Transcript

ROBERT SIEGEL, HOST:

An infant known as the Mississippi Baby raised hopes last year that the AIDS virus could be vanquished from babies with aggressive treatment. The girl had no sign of infection, even after many months without anti-HIV drugs. But doctors at the National Institutes of Health have announced that the Mississippi Baby has now developed an HIV infection. And joining us to talk about this development is NPR science correspondent Richard Harris. Richard, first remind us of the details of the Mississippi Baby case.

RICHARD HARRIS: Well, Robert, the baby was born to a mother infected with HIV. Doctors treated her - the girl - immediately with a combination of powerful anti-HIV drugs. But the mom and the baby disappeared after about 18 months. When they reappeared some months later, the mother said she'd not been keeping the baby on the drugs, yet the blood test showed that the baby was still free of HIV. They looked and looked and found no trace of it at all.

SIEGEL: This was the very hopeful news.

R. HARRIS: Yes, indeed, it generated a great deal of excitement. For a little perspective, this kind of case is rare in the United States because HIV-infected mothers are usually treated during pregnancy to block the spread of the disease to the child. But that's not done in poorer parts of the world, and as a result hundreds of thousands of babies are born with HIV infections. It would be wonderful if a powerful drug treatment given right at birth could eradicate the virus in these babies and that seemed to be the story for the Mississippi Baby. But of course this is one case. Researchers have also been working on a large-scale trial to test this concept on hundreds of babies.

SIEGEL: What are doctor saying now about the baby's condition?

R. HARRIS: Well, the Mississippi baby is now approaching her fourth birthday and she's been monitored closely for signs of HIV infection. And according to her doctor in Mississippi and officials of the National Institutes of Health, HIV has recently reappeared in the girl's blood. The virus apparently had been hiding out in her body so well that even though they gave incredibly sensitive lab tests they couldn't detect it. But now they've announced the girl is indeed infected.

SIEGEL: And what does that mean for the girl?

R. HARRIS: Well, her doctor put her back on anti-HIV drugs, and the girl will stay on them indefinitely. Her doctor says the good news is the girl otherwise appears to be in good health.

SIEGEL: Richard, what implications does this have for the large-scale study of this approach to treating HIV in infants?

R. HARRIS: The doctor, Anthony Fauci, who's the director of the National Institute of Allergy and Infectious Diseases, says they're actually not going to give up on this study. In a news briefing this afternoon, he said they will need to change the consent forms and possibly the timing for when they stop treatment in babies, but they are planning to move forward with it. That said, I did speak also to a bioethicist at Boston College named George Annas who says in his view, it would be unethical to go ahead with this study if they are basing it on the experience with the Mississippi Baby because now we know that the child was not cured of HIV. So there clearly are some ethical issues yet to be sorted out here.

SIEGEL: That's NPR's Richard Harris. Richard, thank you.

R. HARRIS: My pleasure.

MELISSA BLOCK, HOST:

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