The case of the first toddler ever to be "functionally cured" of HIV could have wide-ranging effects on the global fight to end the AIDS epidemic.
"If we can replicate this in other infants ... this has huge implications for the burden of infection that's occurring globally," said Dr. Deborah Persaud, a pediatrician at the Johns Hopkins Children's Center. Persaud is the lead author of a report on the toddler's case that was presented at the 2013 Conference on Retroviruses and Opportunistic Infections in Atlanta on Monday.
"For the unfortunate ones who do get infected, if this can be replicated, this would offer real hope of clearing the virus."
Some 1,000 infants are born with HIV every day, according to the latest estimates from the UNAIDS Global Report. That means some 330,000 children are living with the deadly virus. The majority of these infections are in the developing world.
The most common way children get HIV is through perinatal transmission -- HIV transmission from an infected mother to a child while she is pregnant, giving birth or when she breast-feeds the child.
The number of infant infections in the United States has gone down some 90 percent since the mid-'90s, according to the Centers for Disease Control and Prevention; that's in large part because pregnant women are routinely tested. When a mother is identified as being HIV positive, her doctor is then able to administer preventive interventions that will, in most cases, keep the virus in check.
In developing countries, infants born to mothers with HIV are not so lucky. There, mothers are less likely to be treated with antiretroviral drugs that would prevent transmission during pregnancy. In North Africa and the Middle East, for instance, 3 percent of pregnant women with HIV received antiretroviral medications, according to the U.N. report. Some 23 percent in West and Central Africa did. Testing is also less sophisticated in these areas.
The unidentified Mississippi woman in this case had no prenatal care and was not diagnosed as HIV positive until just before she delivered the baby. That's why Dr. Hannah Gay, an associate professor of pediatrics at the University of Mississippi Medical Center, administered the drugs within 30 hours after the baby was born.
Typically, a baby born to a woman with HIV would be given two drugs as a prophylactic measure. Gay said her standard is to use a three-drug regimen to treat an infection. She did this on the Mississippi infant without waiting for test results to confirm the baby was infected with HIV.
Gay thinks the timing may be key, that the timing may deserve "more emphasis than the particular drugs or number of drugs used."