Are we a step closer to finding a cure? In 2008, Timothy Ray Brown, known as “The Berlin Patient”, was the first person reportedly “cured” of HIV. Six years, since having a series of complex medical procedures, which included chemotherapy and a bone marrow transplant, he has no detectable levels of HIV. This week, the media is in a frenzy over a second possibly cured patient—this time a two-year-child, the Mississippi baby. The infant is now two-and-a-half-year-old and needs no antiretroviral drugs. The baby tested positive for the virus at birth, she became infected because the mother was not tested in early pregnancy and was not given antiretroviral treatment to prevent mother-to-child transmission (PMTCT).
By the time the doctors realised that the mother had HIV, it was too late for the normal PMTCT protocol, so instead as soon as the baby was born, 30 hours after birth, it was given the full three antiretroviral drug combinations as opposed to the single dose ARVs normally given to babies. This baby continued treatment for 18 months till the mother stopped bringing the infant for treatment. However when the infant returned six months later, when tested (note the infant had not been on ARVs for six months) the infant was found to have an undetectable viral load.
Scientists refer to this as a “functional cure”—when people test negative for the virus but some of the virus has remained but is inactive. Normally, babies treated with this drug complement stay on treatment, but this mother never came back for more treatment so this unexpected event of the baby not continuing treatment is how the scientists derived their “functional cure”.
Is this the big one? Do scientists have the cure? Unfortunately, it is not as simple as that. What this “functional cure” does provide is exciting new areas for research. This is one HIV-free baby may also be an exception to the rule. It is possible that this baby, for reasons unknown, may be different to other babies. More rigorous research is required before scientists can determine whether newborn babies can be treated in this way. Furthermore, this potential treatment may not work when HIV is discovered later such as with adults.
What does this mean for Malawi? Unfortunately, with most new and improved treatments, developing countries are always the last ones to benefit. Odd, when places like Malawi are the most in need. But at the same time, there are effective methods of preventing mother-to-child transmission if HIV is detected early and the mother put on ARVs.
