What we heard from the researchers who presented the case on March 4 was that a baby girl, born in Mississippi to a woman with HIV, was found with HIV in her blood shortly after birth. Care providers quickly started the infant on a full set of three HIV medicines (typically, only one or two are used in exposed babies to prevent infection).
The medicines were continued for 18 months, after which mother and child went missing from care. When they returned after almost five months without medicines, no evidence of active HIV infection was found in the child. The medical team performed an exhaustive array of tests to try to confirm the prior presence of HIV and its subsequent eradication, and to rule out rare forms of resistance to HIV infection.
In the case of the Mississippi baby, we know she was exposed to HIV, had HIV in her blood, and that at least some cells in her blood were found with sleeping virus—though we will likely never know if those cells were from the child or maternal cells that had been transmitted during pregnancy or birth. Was the baby infected with HIV and, thus, cured?
To many of the researchers at the conference, the answer is “no.” It seems more likely that her treatment prevented her, after exposure to HIV, from being infected. The reason we give medicines to both pregnant women and their newborns is precisely to prevent HIV exposures in children from becoming established infections, an intervention that can decrease the rate of transmission from about 30% to less than 1% in optimal conditions.
This is, of course, upsetting news. But it is not a setback, promises Siedner. He and other researchers and those in the field of HIV care continue to work toward a vaccine, a cure and better therapies.
But now, he added, speaking to those with HIV about the “cured baby” means taking extra care with the words he and other in the HIV field use.
But the word “cure” and the hope it brings have remained in the minds of many, leading to countless questions from many of the more than 30 million people infected with HIV world-wide, as well as friends, families and care providers. For now, their questions are mostly unanswered.