HIV/AIDS Botched Cure: A blow to Africa’s raised hopes

 

The latest revelation on the ‘Mississippi Baby’, who was widely reported as cured of HIV some years ago, serves as a stark reminder about the elusiveness of HIV.

In 2010, an HIV specialist at the University of Mississippi Medical Centre allegedly treated a new-born baby girl with a heavy dose of antiretroviral therapy (ART) after learning her mother was HIV positive.

This swift action was believed to have staved off the viral infection, and the ‘Mississippi Baby’ was hailed as the first person to be cured of HIV.

But four years later, after two years of medication, doctors involved in the case revealed that the HIV virus has returned ‑ a sad story to millions of people affected by the scourge, especially in Africa.

The National Institute of Allergy and Infectious Disease of United States announced last week that the now four-year-old Mississippi Baby, does not only have the virus, but her immune system also shows signs of damage.

The sad part is that HIV that once reportedly vanished from her system has bounced back and that the toddler now has to face years, if not the rest of her life on medication.

This is not just a disappointment to the little girl and her parents or the medical team that treated her, but it is a global disappointment, especially for Africa as this was considered to be a promising new treatment for infants born with HIV and a great hope for the continent where HIV is a major health challenge.

Thousands of babies are born to infected mothers every year, mostly in poor countries. 

About 90 percent of HIV infections in infants and children are reportedly the result of mother-to-child transmission and the case of the ‘Mississippi Baby’ could have given security and hope to millions of innocent children.

The ‘Mississippi Baby’ was born to an HIV-positive mother in 2010. 

The mother had not received prenatal care, so was not identified as being HIV-positive until she was in labour.

 To stop the baby’s infection, doctors tried an aggressive combination of drugs soon after birth.

When doctors from University of Mississippi Medical Centre of United States announced on March 2, 2013, that the baby was functionally cured of HIV virus, the world hailed the news as a monumental medical breakthrough.

However, Dr Hannah Gay, who treated the baby, remained on the lookout for HIV infection.

“So, last week was one of those regularly scheduled visits,” Gay was quoted as saying. “The child came; she had no abnormalities on physical exam. 

But blood tests showed that the baby had an active HIV infection. 

The virus had emerged from some mysterious hiding place in her body.” She told US media that the new results were disappointing.

“It felt very much like a punch to the gut,” Gay said in a Press statement issued by the National Institute of Allergy and Infectious Diseases. “It was extremely disappointing.”

Despite a reported 24 percent decrease in new infections in children since 2009, UNICEF data shows that around 330 000 children around the world were newly infected with HIV in 2011. Globally, 3.3 million of children under 15 are living with HIV, with more than 90 percent of these children living in sub-Saharan Africa.

These findings should be a signal around the world that much needs to be done.

The Mississippi baby case indicates that early ART in the HIV-positive infant did not completely eliminate the reservoir of HIV infected cells that were established upon infection but may have considerably limited its development and averted the need for antiretroviral treatment. Clinical researchers in this field should strive to find what caused the virus to re-emerge and what could be done to extend HIV remission in the absence of ARV.

Researchers must now strive to understand what enabled the child to remain off treatment for more than two years without detectable virus and what might be done to extend the period of sustained HIV remission in the absence of antiretroviral therapy.

July 2014
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