A toddler in the USA has been “functionally cured” of HIV. Our resident blogger Mario tells us what this actually means…

The story began in Mississippi, USA. A mother with HIV gave birth to a baby girl who was also infected. The mother was not tested for the disease early in her pregnancy and so did not receive antiretroviral drugs (ARVs), which would have significantly reduced the infection risk. In high-income countries, mothers with HIV are usually treated with antiretrovirals (ARVs) to prevent passing the infection onto their child; this treatment can reduce the risk of transmission to just 5%.

The baby girl tested positive for HIV within hours of delivery, which suggested that she was probably infected in utero.

Doctors then resorted to plan B—they gave the baby a cocktail of powerful ARVs to knock the virus over the head as quickly as possible.

The baby girl received this treatment for several months and thrived. Regular testing showed no signs of the virus. Then the mother stopped taking the baby girl for check-ups for months because of “life changes”.

Over this period, it also turned out that the mother had also stopped giving the child ARVs. When doctors finally caught up with the baby girl they expected to find her blood teeming with HIV. But astonishingly all test results were negative. The baby girl had been functionally cured.

This shouldn’t be confused with an outright cure. Traces of the virus still circulate in the baby’s blood, but they are inactive. The powerful ARVs seemed to have stopped HIV from inhabiting the baby girls CD4 cells, a type of immune cell in which HIV hides and shields itself against ARVs.

This baby girl has pulled off what some might call a medical miracle, and she doesn’t even know it. We should also spare a thought for the challenges she will face as she grows up. Let’s not forget that her mother has HIV.

The story of this child is exceptional; it may even be a game changer. Perhaps this is the start of new path that could lead to the end of mother-to-child transmission of HIV (which caused 330,000 infections in 2011). We can only hope.

This “functional cure” opens up new and exciting avenues for HIV/AIDS research. But until we truly understand the implications of this development, we must not forget the importance of other well-established prevention methods, like the humble condom.

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