Amid all the excitement, debate continues on two fronts. First, was the child truly infected? The low viral load was a very unusual but not unheard-of finding, meaning we may never know the truth. Second, does the current spate of normal tests truly indicate a cure? With ultrasensitive testing, the child does have some evidence of scraps of HIV in its [sic] bloodstream, not enough to duplicate and then spread but still something that remains present, at least in shadow form. That’s not nothing. And 10 years of stability is but a moment of time for HIV, for which progression is measured in years.
Therefore, “cure” or even “functional cure” seems a reach. A stable suppression in the absence of ongoing therapy would be a more accurate description—and one that likely would have been used in a less dramatic and headline-grabbing disease.
My issue is also with the word “cure”. The child is still infected, but her own immune system is keeping it in check after a period of strong anti-retroviral treatment. Her levels are as undetectable as mine. But perhaps because she was treated so quickly and aggressively, as her body was still developing, it was neutered before it could get more firmly established in her own DNA.
As Sepkowitz notes, there is already a cure for children born to mothers with HIV: anti-retroviral treatment of the mother in pregnancy. One of my hopes for Obamacare is that rural mothers like the woman who gave birth to this child can get tested and treated for HIV so that they don’t need a new miracle “cure” to keep their children healthy.
(Photo: HIV in yellow infecting a CD4 cell in blue. Via NIAID via Flickr.)