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 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.
The worldwide study planned by the NIH continues in 2023 at 50 sites as clinical trial NCT02140255 under the same principal investigator.
Background
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.
Antiretroviral therapy was continued and the baby was tested at 6, 11, and 19 days of age. All three tests were positive for HIV. At age 29 days, she was tested again and HIV levels were found to have dropped below detectable levels. During the girl's first year, she was not breast fed and adherence by the mother to the antiretroviral therapy was determined by examining pharmacy records and by HIV testing. During this time, adherence to the therapy regimen was determined to be adequate.
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.
The mother of the Mississippi baby tested positive for HIV 24 months after delivery. She began antiretroviral therapy 26 months after delivery and was still positive for HIV 28 months after delivery.
As of July 2014, the child was 46 months old.
Reported cure
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".
Robert F. Siliciano hypothesized that the infant girl received antiretroviral therapy before producing memory T cells, which are immune cells that can serve as a viral reservoir for HIV. If treatment is received before they develop, there may be no place in the body for HIV to hide from antiretroviral drugs.