From Paris: Beyond ‘The Mississippi Baby’ and scary news for transgender women

Photo courtesy Pixabay

The latest HIV news is way too impactful not to report.

Longtime followers of my page know that I essentially made a name for myself in health reporting because of my always-first coverage of HIV issues for several national websites from 2013 to 2016.

Over time, clients have changed, and my HIV reporting has fell by the wayside. I plan to do my darndest to change that soon, with or without paid HIV reporting clients.

Today there are several exciting developments to report. It’s all coming out of the International AIDS Society Convention going on right now in Paris.

Beyond ‘The Mississippi Baby’

Conference attendees learned today that a South African child has been in HIV remission, without drugs, for almost a decade.

You might remember the so-called “Mississippi Baby,” which managed to live HIV-free in theory because doctors detected the virus at birth. The child immediately was put on antiretroviral medication, but the virus rebounded once the medication stopped.

But 10 years in remission, without drugs, is a new accomplishment altogether.

“Further study is needed to learn how to induce long-term HIV remission in infected babies,” said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH). “However, this new case strengthens our hope that by treating HIV-infected children for a brief period beginning in infancy, we may be able to spare them the burden of life-long therapy and the health consequences of long-term immune activation typically associated with HIV disease.”

Read more: Hearing Dr. Fauci of the NIAID speak at ACP Convention a huge thrill

According to a news release from Fauci’s office, “Before starting treatment, the child had very high levels of HIV in the blood (viral load), but after beginning ART at about 9 weeks of age, treatment suppressed the virus to undetectable levels. Investigators halted treatment after 40 weeks and closely monitored the infant’s immune health, and the child has remained in good health during years of follow-up examinations. Although it was not standard practice in South Africa to monitor viral load in people who were not on ART, recent analyses of stored blood samples taken during follow-up showed that the child has maintained an undetectable level of HIV.”

In a nutshell, this is huge.

“To our knowledge, this is the first reported case of sustained control of HIV in a child enrolled in a randomized trial of ART interruption following treatment early in infancy,” said Avy Violari, F.C.Paed, in the NIAID news release. Dr. Violari co-led the study of the case reported today.

“We believe there may have been other factors in addition to early ART that contributed to HIV remission in this child,” added Caroline Tiemessen, Ph.D., whose laboratory is studying the child’s immune system. “By further studying the child, we may expand our understanding of how the immune system controls HIV replication.”

Hormone therapy for transgender women may interact with HIV medications

Unfortunately, there is also bad news coming out of Paris today: Hormone therapy for transgender women may interact with HIV medication.

This is particularly alarming given the fact that transgender people already are at tremendous risk for HIV infection.

Read more: Does cannabis slow the spread of HIV? My 2014 report

According to the NIAID news release:

“Despite all indications that transgender women are a critical population in HIV care, very little is known about how to optimize co-administration of ART and hormonal therapies in this population,” said Jordan Lake, M.D., study leader at the University of California, Los Angeles David Geffen School of Medicine, who is currently continuing this research at the University of Texas Health Sciences Center at Houston. “This study suggests this void of information may mean some transgender women forgo life-sustaining HIV medications, identity-affirming hormone therapy, or some combination of the two. By exploring the extent to which this is happening, we can find ways to better serve this population.”

The study included 87 women receiving treatment at a community-based AIDS service organization in Los Angeles.

Says Fauci: “The best thing a person living with HIV can do is to start and stay on safe, effective antiretroviral therapy, both to maintain their own health and to prevent sexual transmission of the virus. We need to ensure we understand the perspectives of groups disproportionately affected by this pandemic to provide the best health care for them. Further study is needed to help determine how health care teams can optimally tailor care and treatment for those living with HIV.”

Read more: My 2014 special report on why supporting the transgender equality movement is a matter of public health

Stay tuned to @DavidHeitzHealth on Facebook, @DavidHeitz on Twitter, and for more news coming out of IAS.

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