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In a blow to hopes for an imminent HIV cure, the so-called ‘Mississippi baby’ who was apparently cured of HIV in 2013 has been found to still have the virus.
The US child, who was born prematurely 4 years ago, was reported to have been ‘functionally cured’ of HIV in March 2013. She had been administered anti-virals within 30 hours of her birth and was given treatment for a further 18 months before she stopping coming in for treatment.
Some weeks later, the young girl was tested again, and Dr Hannah Gay noticed the virus had seemingly stopped replicating. Dr Gay, the pediatric HIV specialist responsible for the baby’s early treatment, had prescribed a particularly strong form of treatment – using not the usual one or two but instead three different anti-viral medications in combination to halt the spread of the virus.
The young girl had gone 27 months without treatment and was considered functionally cured. Tests last week, however, have confirmed the child still has the virus and that it has begun replicating again. The child has been placed back on anti-virals.
Dr Gay, whose claim of a cure was previously criticised by some sectors of the medical establishment, described these latest developments as ‘a punch to the gut’.
About 250,000 children are born every year with HIV. It was hoped that the Mississippi baby might yield a clue to treating babies born with the virus.
At a press conference on Thursday, the Director of the National Institute of Allergy and Infections Diseases, Dr Anthony Fauci, said:
‘Certainly, this is a disappointing turn of events for this young child, the medical staff involved in the child’s care and the HIV/AIDS research community.’
Another child in California had been given the same treatment and doctors had, in March, claimed they had found no trace of HIV in the baby after nine months of treatment. That case was not considered a cure, however, because treatment was still ongoing – but now it seems the chances of a cure for that baby may also be unlikely.
Dr Rosemary Gillespie, Chief Executive at Terrence Higgins Trust, said: ‘This story is a disappointing reminder of just how far we have to go to defeat HIV. It is a remarkably tenacious virus, which exploits a number of “hiding places” inside the body to survive. Though daily drug treatments can keep it under control, once someone has contracted HIV they will have it for life. Using condoms remains the best strategy to avoid infection.
‘We’re fortunate in the UK to have a world-leading antenatal screening programme, which means that women living with HIV can have children safely, with a very small risk of the virus being passed on. In the western world we have the tools to ensure that no child is born with HIV, so cases like this are both rare and concerning.’
Another possible ‘cure’ has been pursued through bone marrow transplants after a patient in Germany (the so-called ‘Berlin Patient’) was apparently cured this way. Two patients in Boston were undergoing the same treatment but, after months where it appeared the virus had disappeared, the virus appeared to return.
Meanwhile, hope rests on a treatment being pioneered in Dresden’s Technical University called ‘molecular scissors’. A special enzyme is used to identify the virus and remove it from host cells. This has proved 90 percent effective in early trials with animals.
Professor Joachim Hauber, head of the antiviral strategy section at Dresden Technical University’s partner research lab at Hamburg’s Heinrich Pette Institute, said: ‘There are various methods and similar approaches, but removing the virus from infected cells is unique.’
The treatment has so far only been tried on mice, but has been shown to work.
‘The amount of virus was clearly reduced, and was even no longer to be found in the blood,’ said Hauber.
One of the major barriers to finding a cure for HIV is funding – treating the virus is very lucrative for pharmaceutical companies and the cost of clinical trials is expensive.
The head of Infectiology/HIV at the University Clinic Bonn and former president of the German AIDS Society, Professor Jürgen Rockstroh, confirms this: ‘The climate for private investment in HIV/AIDS research these days is very limited.’