HIV lessons from Mississippi Baby setback | Asia Pacific

HIV lessons from Mississippi Baby setback

HIV lessons from Mississippi Baby setback

Updated 21 July 2014, 12:28 AEST

Where HIV and AIDS is concerned, the science is rarely settled.

Medical researchers were disappointed earlier this month, when what was thought to be a very promising breakthrough against AIDS turned out to be too good to be true.

Doctors in Mississippi in the US, had reported a few years ago, that they had cured a local baby girl of the HIV she born with.

Last week, they revealed that the virus has since returned to infect the toddler.

AIDS 2014 co-chair, Professor Sharon Lewin says while disappointing, the news was not all bad.

Presenter: Sen Lam

Speaker: Professor Dr Sharon Lewin, Head of the Department of Infectious Diseases, Alfred Hospital and Monash University; Professor Lewin is also co-head, Centre for Biomedical Research, Burnet Institute in Melbourne

LEWIN: Yes, that was a surprising and disappointing result, of course, for the child herself, and but also that we've been reminded about how difficult it will be to find a cure or a way for people to safely stop treatment.

However, within that sobering news, there was also some encouraging news. The Mississippi baby remained off treatment and essentially virus-free for over two years. Usually when a person on treatment stops their treatment, the virus comes back within one to four weeks, so that period in which the child is off treatment and virus-free of over two years is quite remarkable. And so those as reports and cases are really instrumental in refining the questions that scientists need to ask, why did the baby manage to keep the virus under control for that long? And then why did it come back after so long off treatment? And so that's generated a lot of new questions.

LAM: But it's not all bad news, though, in the fact that because the baby had early treatment, it gave her a bit of a fighting edge, is that the right reading?

LEWIN: Well, we've known for a long time, that if you give early treatment, usually within weeks to months, you substantially reduce the amount of virus that persists long term. The child, in this case, received treatment within hours to days of infection and the hope was that you'd stop the virus from actually finding and embedding itself into its hiding places, but clearly that did happen in this situation, because the virus re-emerged at a later date. So I don't think it's all bad news. I think it has demonstrated to us the challenges that we need to face and also raised the challenge to be can we prolong remission or a time that someone can safely stop anti-retroviral therapy from weeks to years and then from years to decades, which is the overall goal.

LAM: Do you think though, that this case tells us that where HIV is concerned, the science is rarely settled, that as soon as you make some gains, fresh challenges emerge?

LEWIN: Yes and no. I think in some areas, we've been tremendously successful with HIV, look at anti-retroviral therapy, we have effective control of the virus over decades, often people taking one tablet a day, drug resistance extremely rare, side affects reducing and cost also reducing. I think you couldn't get much better than that and that was a tremendous advance. And then in other areas, yes things have been, the science is quite difficult, such as in developing a vaccine and I think likewise, in finding a long term cure. But that doesn't mean it's impossible.

LAM: According to UNAIDS, last year, 19 billion dollars was available for the global HIV response. What's your understanding of how that funding is spent or indeed, how should that funding be spent, should it be equally divided between research and treatment, or is one field more vital than the other in the search for a proper response?

LEWIN: I think in tackling HIV, we need a multi-pronged approach, we need to ensure that we can prevent new infections and the strategy in that area is around education, condom use and modern day prevention interventions. We need to be sure that people know their status and know if they are infected and can access treatment and stay on treatment, and we need research to know that what we're doing works or not, or what's called operational research. And I think those three approaches have to go hand-in-hand.

LAM: But, as a scientist yourself, do you think that globally that research, HIV research is well funded or under resourced?

LEWIN: It's a difficult question to answer. I think more money always leads to more advances and a capacity to bring new people into the field. I think that with the research dollars always a tough and competitive dollar and so HIV researchers will be competing with other diseases. I think what's important is that the research is top quality, competitive, collaborative and ultimately leads to change for people living with HIV.

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