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HIV: The promise of the ‘Mississippi Baby’

By Special to the NNPA from The Black AIDS Institute
On August 11, 2014

Reaction to reemergence of HIV in the ‘Mississippi Baby’– initially thought to be
functionally cured – was mixed at the AIDS conference.
Credit: Angela Hill/News Talk Radio

MELBOURNE, Australia – Is the glass half empty – or half full? That was the framework for thinking about the so-called Mississippi baby case brought up late last month at the International AIDS conference here.

The glass was decidedly half empty in July with the news that the baby, thought to have been cured of HIV, had rebounded with detectable levels of the virus in her blood. Quick as a heartbeat, cure was downgraded to remission.

But today in the convention hall, the glass was much more full – or at least the spin was clearly positive. At a special press event, “Toward an HIV Cure,” a group of scientists, insisted that the case of the baby, now a little girl, was less a setback than a way forward. The gathering at the media event also pointed to several new studies that offered information that might lead to hope for a cure.

“There is plenty of data that are telling us that we can make progress,” said Francoise Barre-Sinoussi, a Nobel-prize winning scientist and co-chair of the conference. “There is no reason not to be optimistic.”

Even the virologist involved with the Mississippi baby, Dr. Deborah Persaud., associate professor of pediatrics and infectious diseases at Johns Hopkins Children’s Center, called her case “a major step forward.” After all, the time the baby’s virus stayed under control without treatment was significantly longer than ever witnessed before -- 27 months.

“I want to emphasize while we are very disappointed for this child, that now requires anti-retroviral treatment to control her virus, this is really unprecedented for the field,” said Dr. Persaud.

The baby was born prematurely in a Mississippi clinic to an HIV-positive mother in 2010. Her mother didn’t receive anti-HIV medication during pregnancy and didn’t know she had contracted the virus until delivery. Right after birth, the infant was treated aggressively and continued on medication until 18 months of age, when doctors lost contact with mother and child. But when the child was again seen by medical staff five months later, they could find no trace of HIV – and she remained virtually free of the virus for more than two years.

But by the time the child turned four, the HIV had returned and the preschooler is now back on medication. 

“As a scientist failures are often more important than successes,” explained Dr. Steven Deeks, an HIV/AIDS researcher and professor of medicine at the University of California, San Francisco. “So I actually perceive the Mississippi baby scientifically as a great success.”

The three new studies outlined at the press event produced mixed results, though the glass-half-full scientists in Melbourne focused on the “the teaching moments.” All of the studies, including the Mississippi case, point to a latent reservoir of HIV that makes the devious virus hard to combat.

One study, conducted on monkeys, found that HIV reservoirs form even before the virus can be detected in the blood. There, according to investigators at Beth Israel Deaconess Medical Center (BIDMC), HIV can lie dormant and avoid being killed off by anti-AIDS medication. The study was published on July 20 in the science journal Nature.

The second study examined the size of the reservoir using a novel measure. And the third, looked at a drug to kick or shock the virus out of the reservoir where it can hide. This study, released late last month and conducted at Aarhus University Hospital in Denmark, excited the audience – though the lead researcher

Ole Schmeltz Søgaard called his work “a small step.” At this point no one is sure how to kill the virus once it’s kicked out into the open.

Dr. Deeks disagreed. “Ole’s data is the first clear evidence that we can truly identify the latent reservoir, the hidden virus, and shock it out of its latency,” he said. “That is the single most important advancement at this meeting and will have a huge impact for the future.”

Linda Villarosa operate the City College journalism program in Harlem and writes frequently about health and social issues. Follow her on Twitter at @lindavillarosa.

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