Mycobacterium avium complex (MAC) is a group of bacteria that are related to tuberculosis. These germs are very common in food, water, and soil. Almost everyone has them in their bodies. If you have a strong immune system, they don't cause problems. But they can cause serious illness in people with HIV (human immunodeficiency virus). With the right combination of medications, however, you can prevent or treat MAC. In some cases, you may need lifelong therapy.
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. At 9 months old, that baby was still HIV-negative.
The Mississippi baby tested HIV-free for more than 2 years, but at age 4, tested positive for HIV. 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 of the Mississippi child 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.