A recent news story has broken about a baby born with HIV in rural Mississippi that was given aggressive triple therapy of antiviral treatment shortly after birth and then kept on a program of antiretrovirals for ~two years. The report goes on to say that the child, now 2 1/2 yrs old has been off its (excuse the pronoun, privacy concerns have prevented even the release of the sex of the child) drugs for a number of months with no sign of virus.

Stop therapy, viral load spikes…

This is a fairly typical way of monitoring viral persistence because it cannot be detected at very low amounts, but infected individuals typically see a resurgence in viral load following treatment cessation.  This can be seen in the graph to the right presenting the viral load in an individual given structured treatment interruptions (times when the patient came off antiretroviral drugs).

Unfortunately, news of this treatment has broken ahead of publication (the case was presented at the  Conference on Retroviruses and Opportunistic Infections in Atlanta. The only data available is from the abstract of the presentation indicating that the baby tested positive to HIV five separate times within the first three weeks of life, but at two years of age no detectable virus was found despite some molecular tests indicating very low levels of HIV DNA.

Are you sure there’s NOT ONE black grain of sand on this beach?

Once the data are published, it will be very interesting to see if the child convincingly tested positive early in live and that it continues to test negative into the future. If the child never did have HIV, it’s not very remarkable that it still doesn’t. Similarly, it is important to continue monitoring this child to ensure that measurable virus levels do not return. It’s terribly difficult to prove a negative, but that’s what this group must attempt to do to support their claims.