In the latest case, a Mississippi woman, who was infected with H.I.V., did not get treatment during her pregnancy. Doctors gave her baby a three-drug treatment-strength regimen, some 30 hours after birth. They continued the treatments for 18 months, after which the mother stopped going to the hospital and stopped giving her baby the drugs.
Five months later, the mother returned with her child, who turned out to be free of the active virus. The baby, now 2 1/2 years old, has been free of the active virus ever since. Although very sophisticated tests can find traces of the virus, it is not able to replicate and spread. This is described as a “functional cure.”
There are reasons to treat this apparent breakthrough cautiously. Researchers must still demonstrate conclusively that the baby had truly been infected and was not simply prevented from absorbing its mother’s infection — a process achieved routinely in many babies. They must also show that this is not an exceptional, nonreplicable case with an atypical baby, but that the same treatment would work in other newborns.
If the stronger early treatment is confirmed to work, it could become the standard of care around the world. Fewer than 200 babies a year are born with lasting H.I.V. infections in the United States, but some 300,000 babies a year are born with such infections abroad.
Even if the treatment works, the best defense against mother-to-child transmission is still prevention, which will always be preferable to treatment after an infection has set in.Apart from the truism of the last paragraph, we might reflect on the implications: If such a cure is possible, 300,000 babies yearly will need it. This will put a new burden on countries with high HIV rates (which tend to be very poor countries) and on the donors and agencies that now provide antiretroviral drugs.
Wikipedia, citing UN reports, tells us that 6.9 million children under age 5 died in 2011—half of them in sub-Saharan Africa. While this is mercifully less than the 12.4 million who died in 1990, it still amounts to a yearly Holocaust, inflicted mostly by such banal causes as respiratory infections, diarrhea, measles, malaria, and malnutrition. They need no miracle drugs, only clean water, nourishing food, and a few cheap vaccinations.
Every HIV-positive child deserves to live. So do the millions of others who won't live to see their fifth birthday.