Physicians treated the child with the antiretrovirals after Richman confirmed through assays that she was HIV positive. At 23 months, after five months of not showing up for follow-ups, the child returned for HIV treatment; however, tests confirmed the absence of HIV. “They did all the right tests and started treating the baby with the first couple of days, and that is what resulted in this remarkable outcome,” Richman said.
Richman explained that roughly 300,000 babies are born infected with HIV each year, down from the millions born in the past, due to pre-natal care with the intervention of drugs. This particular child did not have pre-natal care, so preventative care could not be implemented.
The research that led up to curing the Mississippi child of HIV has been ongoing for decades. Richman’s research on HIV goes back to the early ’80’s when AIDS became a prevalent infectious disease among his patients. His lab was one of the first to uncover the latent reservoir of HIV, the major obstacle of curing HIV using antiretroviral therapy.
“Antiretroviral therapy is one of the major accomplishments of medical research in the last 25 years and it’s changed [HIV]it from a death sentence to a chronic disease, but patients have to stay on their medications for life,” Richman said. “So when we discovered this latent reservoir was the obstacle of the cure back in ’97, we have been trying to figure out how to eradicate that reservoir.”
Recently, Richman has been working to quantify and categorize the reservoir by cell types and anatomic compartments, which can help researchers understand the size of the reservoir and whether or not intervention can help change its size.
“[It] is really understanding the biology and being able to measure the effectiveness of those candidate interventions that are just being designed now,” Richman said.
Moving forward, Richman stated that replicating the results as seen in the Mississippi child is necessary in order to confirm that it happens more than once. If there is confirmation that these results can be replicated, Richman believes it will have an impact on management strategies with newborns.
“This whole issue of curing HIV — , the eradication strategy — is going to take at least a decade more to accomplish on a major scale,” Richman said.