The Mississippi baby who had been “functionally cured” of her HIV infection now has detectable levels of virus. It’s a sad turn of events, but not necessarily a surprising one.

You can read more about the Mississippi case in Popular Science‘s 2013 explainer. In short, the baby received an aggressive course of standard anti-retroviral treatment just 30 hours after she was born. Then, because her mother stopped bringing her to the doctor, she didn’t get treated for a few months. Yet once doctors saw her again, they found no evidence that HIV was replicating in her blood—an unprecedented result. So researchers began hoping that perhaps aggressive early treatment could help other babies born with HIV. They set up a clinical trial to test this.

At the same time, the Mississippi baby’s doctors did find fragments of HIV DNA in her blood, a sign that she could still be infected. Commentators warned how unlikely it was this was a true, lifelong cure. Surely the girl’s doctors knew this, too. It was a watch-and-wait situation, but everyone was hopeful.

Now, the girl is almost four years old and she’s having “an unequivocal relapse” with significant numbers of virus in her blood, as AIDS expert Dr. Anthony Fauci told the New York Times. Her caretakers can still manage the virus with anti-retrovirals, but if her infection is like others’ and HIV treatments don’t improve, she’ll take those drugs for the rest of her life. That’s not a terrible fate—many folks in the U.S. live with HIV—but it has its challenges.

Researchers will now reconsider how they’ll run the clinical trial they set up for other babies born with HIV, the New York Times reports.

New York Times

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