Antiretroviral therapies have brought renewed hope for many people living with HIV. However, they do not offer a cure, and they can cause many side effects.
For these and other reasons, more than 70% of HIV-positive people have turned to alternative medicine for help. Some people use alternative medicine instead of standard Western medicine. However, most people choose to use alternative medicine along with standard Western medicine. This is called "complementary" or "integrative" medicine.
Now, one of them is testing positive for HIV again.
But the treatments at least held the virus at bay for a while -- and that could lead to changes in treatments for people recently infected.
Where HIV Hides
Usually, babies who might be HIV positive get medications to prevent the virus. Only when two tests come back positive are they switched to drugs that treat HIV. By this time, a baby could be 2 or more weeks old.
Sometimes doctors take a different approach, though. A baby from Mississippi received treatment medications just 30 hours after birth, and another baby from California was treated when she was only 4 hours old.
The baby in California is still HIV-negative almost a year after birth. The Mississippi baby tested HIV-free for more than 2 years, but is now HIV-positive again. Her mother had stopped giving her medication when the baby was 18-months old.
Scientists hoped giving strong treatment medications so soon after birth would get rid of HIV hiding in the body, or prevent it from forming.
But the news isn't completely unexpected, says Robert Siliciano, MD, PhD, professor of medicine in the infectious diseases department at Johns Hopkins University School of Medicine.
He says it supports the theory that HIV cells stay in the body, just out of view in a hidden "reservoir."
"Curing HIV infection is going to require strategies to eliminate this reservoir," says Siliciano.
HIV/AIDS expert Anthony Fauci, MD, executive director of the National Institute of Allergy and Infectious Diseases (NIAID), calls the news disappointing "for the patient, the patient’s family, and the researchers." But he says what they learned will help HIV/AIDS research. "I certainly don’t think it’s an advance, but I don’t think it’s a setback,” he says.
People who have HIV should get treated as soon as they know. Now that may mean even earlier.
This is easier to do in babies, who can be tested and monitored right after birth. Adults rarely know exactly when they got infected, but more frequent screening tests may lead to earlier treatment.
If someone tests positive for HIV in a clinic, for example, health care professionals might want to "start treatment and ask questions later," says David Hardy, MD. He's a clinical professor of medicine at the David Geffen School of Medicine at UCLA and a board member of the HIV Medicine Association.
More Research Needed
The Mississippi and California babies will be several years old before there are any related changes to the HIV treatment that most people get. And until there are better tests to find the virus hiding in the body, doctors can't accurately label anyone "HIV free."
Anthony Fauci, MD, director, National Institute of Allergy and Infectious Diseases.
David Hardy, MD, clinical professor of medicine, David Geffen School of Medicine at UCLA; board member, HIV Medicine Association.
McNeil, Donald G. Jr. The New York Times, March 5, 2014.
National Institutes of Health: AIDS Info, Clinical Guidelines Portal: "Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States."
Persaud, D. The New England Journal of Medicine, Nov. 7, 2013.
Deborah Persaud, MD, professor of pediatrics, division of infectious diseases, Johns Hopkins University School of Medicine; scientific chair, HIV Cure Committee for Impact Clinical Trials Network.
Robert Siliciano MD, PhD, professor of medicine, infectious diseases department, Johns Hopkins University School of Medicine