Mississippi baby

The Mississippi baby (born 2010) is a Mississippi girl who in 2013 was thought to have been cured of HIV. She had contracted HIV at birth from her HIV-positive mother. Thirty hours after the baby was born, she was treated with intense antiretroviral therapy. When the baby was about 18 months old, the mother did not bring the child in for scheduled examinations for the next five months. When the mother returned with the child, doctors expected to find high levels of HIV, but instead the HIV levels were undetectable. The Mississippi baby was thought to be the only other person, after the "Berlin patient," to have been cured of HIV. As a result, the National Institutes of Health planned to conduct a worldwide study on aggressive antiretroviral treatment of newborn infants of mothers with HIV infections. It was thought that aggressive antiretroviral therapy on newborn infants might be a cure for HIV. On July 10, 2014, however, it was reported that the child was found to be infected with HIV. Whether the worldwide study planned by the National Institutes of Health will be conducted remains uncertain.

At 18 months of age, there was concern about adherence to the therapy regimen, but HIV levels remained below detectable levels. Between 18 and 23 months of age, the infant missed all clinical visits and the mother reported that she had stopped the antiretroviral therapy when the child was 18 months old—normally therapy would not have been stopped. The infant was tested and HIV levels were unexpectedly below detectable levels. Antiretroviral therapy was therefore not restarted.

On July 10, 2014, at a news conference held at the National Institutes of Health, health experts announced that detectable levels of HIV had been found in the child in tests conducted a week earlier. In two separate tests, they found that her blood levels of HIV had gone from undetectable to 10,000 copies of HIV per milliliter. According to Anthony Fauci director of the National Institute of Allergy and Infectious Diseases, this result "is a disappointing turn of events for this young child, the medical staff involved in the child's care and the HIV/AIDS research community". Hannah Gay told NPR that the re-emergence of the virus "felt very much like a punch to the gut". The Mississippi baby had been off her strong antiretroviral therapy for 27 months. Her HIV status was monitored every 6 to 8 weeks during that time with regular clinical visits.

There is a second baby infected with HIV in California who received antiretroviral therapy four hours after birth. The baby will not be taken off antiretroviral drugs to determine whether she is cured for ethical reasons. As of July 2014, the baby was in foster care because her mother was in an advanced stage of AIDS.

In October 2013, the physicians in charge of the Mississippi baby's antiretroviral therapy reported that at 30 months, 12 months after antiretroviral therapy stopped, HIV levels in the child were found to be below detectable levels. They first reported these results at 2013 Conference on Retroviruses and Opportunistic Infections in Atlanta and subsequently published them in The New England Journal of Medicine. Tests showed that the HIV DNA was still present but at levels similar to those in the only other person thought to be "functionally" cured of HIV (i.e., "control of viral replication and lack of rebound once they come off antiretroviral medications"), the "Berlin patient".

If a mother is known to have HIV, she is given antiretroviral therapy during her pregnancy, which reduces the transmission of HIV to her baby to less than 2 percent (if a mother is untreated, transmission rates range from 15 to 45 percent). Although it is not common in the United States, some mothers do not know their HIV status and are not treated with antiretroviral therapy during pregnancy. In 2011, 127 babies were born HIV positive in the United States, but an estimated 330,000 babies per year are infected at birth by HIV around the world.

In 2010, the "Mississippi baby" was a girl born by spontaneous vaginal delivery to an HIV infected mother at University of Mississippi Medical Center. The mother had received no prenatal care. During labor, the mother was tested for HIV and found to be positive. She gave birth to the baby before antiretroviral therapy could be delivered to prevent the transmission of HIV from the mother to the baby. When the baby was 30 hours old, Dr. Hannah Gay made the decision to begin aggressive antiretroviral therapy before the test results were available. The baby was tested for HIV at 30 and 31 hours of age and found to be infected.