Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Baby cured of HIV: What’s the real story?

Paul Sax, MD
Conditions
March 25, 2013
Share
Tweet
Share

As undoubtedly you’ve heard by now, there’s another person cured of HIV out there — this time, it’s a baby born to an HIV-infected mother.

Here’s the story: The mother didn’t know she was HIV positive until delivery, and the baby was found to be infected by both HIV DNA and RNA right at birth. The doctors started combination antiretroviral therapy approximately one day later, essentially as soon as the results came back. There was a good response to treatment, with declining HIV viral loads over the next few weeks that quickly became undetectable.

Successful treatment continued for 18 months, at which time mom and baby were lost to follow-up; the mom stopped the baby’s antiretrovirals. When the two returned to care 5 months later, the baby’s HIV RNA and antibody were both negative — much to the surprise of the doctors. Supplemental testing, using evaluations similar to those done on the Berlin patient, did not yield any evidence of replication-competent virus, and the baby remains off therapy today.

In short, baby cured of HIV.  Stop the presses! (Do they still say that?)  Front page story, New York Times. Look at this Google News Page. My colleagues and I are all getting e-mails from our friends/family/etc. asking about this “breakthrough.”

And we’re kind of baffled. Because this case will have about as much immediate impact on the HIV epidemic in the United States as the prior cure — that’s right, virtually none. Maybe it will have an impact globally, but that will be a major challenge.

Thinking about it more, however, I understand why this is such compelling news:

  • It’s a baby. The media love stories about HIV in babies. The whole “innocent victim” thing is hard to shake.
  • It’s a cure. Can’t miss that. And the press is probably hypersensitive about not missing out, since they initially whiffed on reporting the last HIV cure. It was first presented at CROI in 2008 and barely got a peep. Took a resuscitation of the story by the Wall Street Journal and, ultimately, publication in the New England Journal of Medicine for the case to receive major media attention. For the record, rumor has it that a certain highly prestigious medical journal (hint) also initially whiffed on it, rejecting the case report when it was first submitted.
  • The public probably doesn’t really understand that HIV in babies is all but 100% preventable. Not emphasized nearly enough in most of the media reports is that the mom didn’t know she was infected until delivery, so she missed out on the key intervention for preventing HIV transmission — treatment of the mom during pregnancy. And since treating pregnant women has long been standard-of-care, pediatric HIV in the United States is vanishing, a real triumph of prevention. Fewer than 200 cases/year in this country, and counting (down).

So what are the practical implications of this case?

First, in developing countries with high HIV prevalence, where perinatal transmission remains a problem, strategies to aggressively treat the newborns of untreated HIV-positive mothers should be implemented pronto. Second, the case will probably teach us a bit more about how we might someday actually cure more than just a single person here and there.

But for now, the headline to this USA Today piece — “Child’s HIV Cure Won’t Mean New Treatments Immediately” — is the understatement of the year.

Paul Sax is the Clinical Director of Infectious Diseases at Brigham and Women’s Hospital. His blog HIV and ID Observations, is part of Journal Watch, where he is Editor of Journal Watch AIDS Clinical Care.

Prev

Twitter makes me a better doctor: 4 reasons why I use Twitter

March 25, 2013 Kevin 6
…
Next

The resurrection of coenzyme Q10: It's all about the money

March 26, 2013 Kevin 5
…

Tagged as: Infectious Disease

Post navigation

< Previous Post
Twitter makes me a better doctor: 4 reasons why I use Twitter
Next Post >
The resurrection of coenzyme Q10: It's all about the money

ADVERTISEMENT

More by Paul Sax, MD

  • An infectious disease doctor answers your COVID-19 and coronavirus questions

    Paul Sax, MD
  • When should physicians read the House of God?

    Paul Sax, MD
  • Should we write that patients are “pleasant” in medical notes?

    Paul Sax, MD

More in Conditions

  • Why peer support can save lives in high-pressure medical careers

    Maire Daugharty, MD
  • Addressing menstrual health inequities in adolescents

    Callia Georgoulis
  • Healing beyond the surface: Why proper chronic wound care matters

    Alvin May, MD
  • Why specialist pain clinics and addiction treatment services require strong primary care

    Olumuyiwa Bamgbade, MD
  • What a childhood stroke taught me about the future of neurosurgery and the promise of vagus nerve stimulation

    William J. Bannon IV
  • Facing terminal cancer as a doctor and mother

    Kelly Curtin-Hallinan, DO
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Life’s detours may be blessings in disguise

      Osmund Agbo, MD | Physician
    • Inside the heart of internal medicine: Why we stay

      Ryan Nadelson, MD | Physician
    • The quiet grief behind hospital walls

      Aaron Grubner, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • Bundled payments in Medicare: Will fixed pricing reshape surgery costs?

      AMA Committee on Economics and Quality in Medicine, Medical Student Section | Policy
    • How Project ECHO is fighting physician isolation and transforming medical education [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Life’s detours may be blessings in disguise

      Osmund Agbo, MD | Physician
    • Inside the heart of internal medicine: Why we stay

      Ryan Nadelson, MD | Physician
    • The quiet grief behind hospital walls

      Aaron Grubner, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • Bundled payments in Medicare: Will fixed pricing reshape surgery costs?

      AMA Committee on Economics and Quality in Medicine, Medical Student Section | Policy
    • How Project ECHO is fighting physician isolation and transforming medical education [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Baby cured of HIV: What’s the real story?
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...