Cured by Negligence, Still in Danger.

At one time, HIV was viewed as one of, if not the greatest threats to global health. Due to advancements in antiretroviral therapy and earlier diagnoses, the virus is now viewed as a manageable disease that is no longer the death sentence it once was. The medical field continues its progress towards finding a cure for the disease, and news that a young child was given a “functional cure” for an HIV infection acquired at birth is cause for hope that similar results can be achieved in adults. However, this optimism should be guarded by the fact that the infant responded to standard antiretroviral drugs that are routinely used in adults already. Furthermore, it should also be noted that the infant was started on this drug therapy a mere 30 hours after birth, well before the virus could establish itself in the child’s system. Adults are unlikely to be aware of being infected with HIV at such an early state, and by the time they receive medical care, the virus will have had time to infiltrate the immune system and set up reserves in the CD4 white blood cells. Nonetheless, if this “cure” can be reproduced in other infants, it marks a legitimate turning point in preventing HIV from become established in children that are born infected with the virus.

Which brings me to the focus of the this article. Everyday, approximately 1,000 infants are born infected with HIV. The majority are born in developing countries where access to medical care is limited at best and prenatal screening of the mother is uncommon. Some may be unaware of the fact that a woman who has HIV can give birth to a child free of the disease. In the U.S. and other developed countries most pregnant women are tested for HIV, and if the results are positive, preventative measures can be taken to ensure that the virus is not passed on to the child.

The mother of the “cured” child did not receive such prenatal screening, and was unaware of her disease status until she delivered the child in hospital. This in itself is troubling. The mother either did not know that she was pregnant, which is not as rare as you would think, or she was not concerned enough for the well being of her child to seek routine medical care during her pregnancy. The issue of cost could have been an obstacle to her getting this care, but most cities have a Planned Parenthood clinics that provide low-cost, and sometimes free, maternal care and prenatal testing. So either ignorance or lack of concern by the mother led to her child being born with HIV.

Fortunately, the child received prompt medical treatment. The child continued to receive antiretroviral therapy for 18 months, until the mother stopped bringing her to the clinic. I repeat, the mother stopped bringing her child to get treated. At this point, no one knew that the child was cured; she could just have well been setting up her child for a lifetime of dealing with HIV. Look at it this way, if the kid had been born with cancer, and the mother stopped getting her baby care, the child would have likely died.

Five months went by before the mother and child returned to the clinic. The physicians were appropriately worried that the child would now have an established HIV infection. Tests revealed this not to be the case, and after several follow up tests, the child was declared “functional cured.” The kid was lucky. The mother, on the other hand, was simply reckless, and should be charged with child endangerment at the minimum. She has shown a pattern of disregard for the health of her child, and the future well being of the child is questionable. These facts have been overshadowed by the news of a “cure” for HIV, but the mother needs to be held accountable for her actions (or inaction as the case may be). The child escaped harm this time, but maintaining that health is in jeopardy as long as she is in the “care” of a negligent mother.