The child known as the “Mississippi baby”—an infant seemingly cured of HIV that was reported as a case study of a prolonged remission of HIV infection in The New England Journal of Medicine last fall—now has detectable levels of HIV after more than two years of not taking antiretroviral therapy without evidence of virus, according to the pediatric HIV specialist and researchers involved in the case.
Born prematurely in a Mississippi clinic in 2010 to an HIV-infected mother who did not receive antiretroviral medication during pregnancy and was not diagnosed with HIV infection until the time of delivery, the infant was started at 30 hours of age on liquid, triple-drug antiretroviral treatment. Testing confirmed within several days that the baby had been infected with HIV. At two weeks of age, the baby was discharged from the hospital and continued on liquid antiretroviral therapy.
The baby continued on antiretroviral treatment until 18 months of age, when the child was lost to follow-up and no longer received treatment. Yet, when the child was again seen by medical staff five months later, blood samples revealed undetectable HIV levels (less than 20 copies of HIV per milliliter of blood, and no HIV-specific antibodies. The child continued to do well in the absence of antiretroviral medicines and was free of detectable HIV for more than two years.
However, during a routine clinical care visit earlier this month, the child, now nearly four years old, was found to have detectable HIV levels in the blood. Repeat viral load blood testing performed 72 hours later confirmed this finding. Additionally, the child had decreased levels of CD4+ T-cells, a key component of a normal immune system, and the presence of HIV antibodies—signals of an actively replicating pool of virus in the body. Based on these results, the child was again started on antiretroviral therapy.
In light of the new findings, researchers must now work to better understand what enabled the child to remain off treatment for more than two years without detectable virus or measurable immunologic response and what might be done to extend the period of sustained HIV remission in the absence of antiretroviral therapy. Learn more from a New York Times news story.Read more