Girl who was declared 'functionally cured' of HIV now has active virus

An infant who was seemingly cured of HIV following aggressive drug therapy just hours after her birth was recently discovered to be infected with the virus that causes AIDS after all, doctors announced Thursday.

The so-called Mississippi Baby, now nearly 4 years old, had raised hopes of a potential cure for babies infected with HIV when it was first described at an AIDS conference last year. It also provided the foundation for a forthcoming clinical trial.

The discovery recently that the 46-month-old child had actually carried the virus at undetectable levels for almost two years before it rebounded suddenly came as a blow to public health officials.

"It felt very much like a punch to the gut," said Hannah Gay, a pediatric HIV specialist at the University of Mississippi Medical Center in Jackson who had treated the girl.

"It was extremely disappointing, both from the scientific standpoint that we had been very hopeful that this would lead to bigger and better things, but mainly for the sake of the child who now is back on medicine and expected to stay on medicine for a very long time," Gay said.

The case had made international headlines.

Born prematurely to a mother infected with HIV, the infant was given a cocktail of three antiretroviral drugs 30 hours after birth. She remained on antiretroviral drugs for 18 months, after which her mother stopped taking her to see doctors and stopped administering the drugs.

Five months later, doctors reexamined the child and found that even though the drugs had been discontinued, her blood showed no detectable levels of HIV and no HIV-specific antibodies. Details were published in October in the New England Journal of Medicine.

The child remained free of drugs - and of detectable HIV - for two years.

But during a routine screening this month, doctors detected the virus in her blood, as well as a drop in her immune cells. After sequencing the virus, they determined it was identical to what had infected her mother - confirming that the baby indeed had HIV at birth.

"There was some doubt as to whether the baby was infected," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "The baby clearly was infected."

The case, the only one of its kind documented, has raised many questions about scientists' understanding of the virus and may raise potential ethical issues regarding a forthcoming study. It is intended to show whether children born to HIV-infected mothers can safely discontinue treatment if they show no signs of infection.