Theresa Mack, M.D., M.P.H.
This is not a cure, but a remission.
Today, there is no cure for HIV/AIDS. The HIV virus can though, be controlled, such that people living with HIV lead healthier, productive lives, and have a normal life span.
This mother was diagnosed with HIV during labor. The standard treatment in the US to prevent HIV transmission to an unborn child is to give the mother during pregnancy antiretroviral medications and perform a C-section if the viral load remains detected. In addition all newborns are treated for 6 weeks with one antiretroviral medication. This treatment protocol is highly successful in preventing HIV transmission to the new baby.
In this case, the medical doctors gave the baby more than just one antiretroviral medication at birth to prevent HIV transmission because the mother was unaware of her HIV status and did not receive the antiretroviral medications during pregnancy. The medical doctors believed more than one HIV medication would be necessary to prevent HIV transmission in this baby. HAART, (Highly Active Antiretroviral Therapy), aka “ HIV cocktail” was initiated at birth and continued longer than the 6 weeks because the baby tested HIV positive.
The mother and child were lost to medical follow-up and the mother stopped the HIV cocktail for the child after several months. At two years of age, the HIV virus in the child remained undetected despite not having the HIV medication for months.
This is an example of remission. The child’s immune system continued to suppress the HIV virus off HIV medications. Knowing your HIV status during pregnancy is crucial in preventing HIV transmission to the unborn child. Prevention is better than cure or remission.
There are many unanswered questions—Is the virus hiding in the baby’s body? Will the HIV virus re-emerge later? Shall all newborns at risk be given more than one HIV medication? How long will this child have an undetected viral load off medications?
This story also underscores the importance of community -based organizations, like Iris House. Iris House would have engaged and fully supported the mother/child and coordinated linkage to care with medical providers through the test and linkage to care services.
Theresa Mack, M.D., M.P.H., HIV specialist, an associate medical director at St. Luke’s Roosevelt hospital center for Comprehensive care in Harlem, N.Y.
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