On one of my favourite podcasts, The Skeptics Guide to the Universe, the hosts talk quite frequently about how poor science journalism often is. I have to admit, it makes me bristle sometimes, just a little bit.
It is fair criticism, however. There is no doubt the mainstream media has a tendency at times, to sensationalize, if not outright get things wrong.
Recently I was listening to the radio and caught a brief segment that went something like: “In a first, doctors in Mississippi have cured a baby of AIDS.”
Even Beta News, a popular science website, ran the story with the headline: “In a First, Baby ‘Cured’ of HIV.”
I get the idea that headlines are supposed to sell the story, but even this one—which properly identifies HIV and uses scare quotes around ‘cured’ has a tendency to mislead.
And, of course, it wasn’t long before people who had not drilled down into the story were talking about how researchers had found a cure for AIDS.
In the first place—and you’d think we’d be over this considering we’ve been talking about HIV/AIDS for more than three decades—there is a difference between being infected with HIV and having AIDS. Human Immunodeficiency Virus (HIV) is the virus that causes Acquired Immunodeficiency Syndrome (AIDS).
In the story in question Mississippi mother found out she was HIV-positive while giving birth. Babies born to mothers who are HIV-positive without being treated by antiretrovirals are approximately 75 per cent likely to also be infected by the virus.
Normally, doctors treat newborns with a single antiretroviral drug for six weeks so they can confirm whether HIV antibodies or DNA/RNA present in the baby are an actual infection or the mother’s passively passed on during birth.
In this case, Hannah Gay, a doctor at University of Mississippi Medical Center, decided this infant’s risk was so great, she would treat the baby with the full-blown three antiretroviral treatment usually reserved for confirmed cases of HIV.
Some of Gay’s colleagues have questioned the ethics of such a course of action, but that would appear moot now. Doctors confirmed the infection and treated the child for 18 months. Then the baby and her mother disappeared for five months.
When they returned, Gay tested the child expecting high viral loads, but was surprised to find no detectable HIV at all.
Of course, the researchers themselves have been very careful from the start to describe the treatment as a potential “functional cure” for HIV infection in newborns.
It may seem somewhat semantic, but it is important to make certain distinctions.
First, it is not a cure for AIDS.
Second, it is not a general cure for HIV because it has limited application to newborns.
Third, it is only a potential functional cure because it has not been replicated.
Finally, functionally cured does not necessarily mean cured. To put it in terms more people are familiar with, the baby is basically in remission.
There is much testing to be done and that is where it gets very tricky; the question of ethics remains paramount.
“The reported ‘functional cure’ is welcome news, but until findings can be replicated and more evidence emerges, it is critical that clinicians continue to follow established guidance for testing and treatment,” wrote Ambassador Eric Goosby, head of the State Department’s Office of Global Health Diplomacy and U.S. global AIDS coordinator.
“We eagerly await further research on these findings and whether the experience of the child can be replicated in clinical trials involving other HIV-exposed children.”
The key here is the word exposed. In order to conduct a proper clinical trial, brand new babies will have to be aggressively treated with the famous anti-viral cocktail before HIV infection is even confirmed.
Even finding a suitable group of subjects for clinical trials will be very difficult.
Nevertheless, researchers are encouraged by the result.
“For pediatrics, this is our Timothy Brown,” said Dr. Deborah Persaud, associate professor at the Johns Hopkins Children’s Center who authored the official report on the Mississippi baby.
Timothy Brown, also known as the “Berlin Patient,” was the first person confirmed to be functionally cured of HIV. In his case, he received a stem cell bone marrow transplant to treat his leukemia from a donor with a natural resistance to HIV.
Brown has been HIV-free for more than five years. Researchers are also awaiting confirmation that two more patients in Boston in HIV remission following bone marrow cancer treatment.
We have a long way to go in the fight against HIV, but any cases such as these offer insight into the disease that could lead to an eventual cure for AIDS.
I can’t wait to write that headline.