Gay teamed with doctors at the University of Massachusetts Medical School and John's Hopkins Children's Center to perform more sensitive tests, and they still found almost no trace of HIV. The child has now been off treatment for 18 months with no sign of symptoms, although trace amounts of HIV DNA and RNA remain in the peripheral blood cells.
When the team of doctors announced the world's first "functional cure" of HIV at the Conference on Retroviruses and Opportunistic Infections in Atlanta, news articles appeared that night in The New York Times and the Wall Street Journal. Soon, word of a "cure" had spread around the globe.
But even the researchers acknowledge that it's possible the treatment wasn't responsible for the baby's outcome.
"I'll say the early treatment most likely contributed to the outcome in this child," Persaud said. "But whether it's the only intervention that allowed this outcome is unclear and requires further study."
Gay said in an email that "it may or may not have happened due to starting aggressive therapy very early, but that is our best guess as to the cause at this point."
How Do We Know It May Be a Cure?
Fauci said the medical community has long believed that the only way to cure someone of HIV is to start treatment as early as possible, before the virus forms reservoirs or damages the immune system, which is what makes it incurable in older children and adults. But Fauci is not celebrating just yet.
"Is it the breakthrough case of the year? Not necessarily," Fauci said. "First of all, you always need to replicate something multiple times. With a single case, you always have to take it with a grain of salt. "The fact remains that it's important proof of a concept that deserves further study," he said.
Although the child is not on HIV medication now, that doesn't mean symptoms won't return, said Dr. Myron Cohen, director of the Institute for Global Health and Infectious Diseases at the University of North Carolina at Chapel Hill, who was present at the conference where the "cure" was announced.
"We desperately want to cure the infection," Cohen said in March. "There's no doubt about our commitment. The big hole is, of course, only massive amounts of time will say whether this child is not infected."
Kline, who has treated children with HIV and AIDS since the 1980s, said calling this a cure, even a functional cure, sends the wrong message to the rest of the world by giving people false hope. It's possible that the child was one of a handful of patients who were born with HIV and were somehow able to control the virus on their own, Kline said.
One of Kline's patients, who is now 22 years old, initially tested positive for HIV and then tested negative just before he started treatment. The patient's test results waffled from positive to negative, and Kline found that he was infected with HIV, but the virus remained dormant most of the time. As such, the patient doesn't need treatment.
"These are unusual cases, and I do think we have something to learn from them, but to say this baby was 'cured' because we gave him powerful medications in the first 30 hours of life, I think that's a real stretch," Kline said.
Immediately following the announcement in March, Kline said he's been bombarded with calls and emails from around the world from people who want to know whether the standard of care for HIV patients should change or whether they should explore stopping therapies for some patients.
It hasn't stopped in the months since, he said today.
"I think we've done a real disservice," Kline said in March. "We might cause some practitioners to erroneously think that now they should be treating every single baby born to a mother with HIV with potentially toxic medication. We're experimenting on babies who, in many cases, are not even infected with HIV."