Here’s what is known: The baby’s mother was infected and had not had prenatal care. After delivery, the baby had some HIV in her blood. Aggressive treatment with a combination of powerful drugs drove the virus to undetectable levels. Doctors were surprised, however, when a long break in treatment (after the mother started missing appointments) didn’t lead to a resurgence of HIV. The virus remained undetectable, though it’s too soon to know if it is permanently gone.
This case was very unusual. HIV infections in pregnant women are routinely detected during prenatal care, allowing time to start effective drug regimens that keep the virus from infecting babies. Such strategies are all but universal in wealthier nations and now reach more than half of infected women in the parts of Africa where HIV is widespread. But given how cheap and easy it is to prevent infection in infants, it’s a tragedy that more than 300,000 contract HIV each year. The developments in the Mississippi case are unlikely to have a direct impact on most of them.
2. AIDS is the leading killer of babies worldwide.
Infant mortality is a scourge of poor nations. But AIDS is not the main cause. Diarrhea, pneumonia and malaria are. Together they are responsible for more than a third of the nearly 7 million deaths annually of children under age 5, according to UNICEF. AIDS is responsible for about 2 percent of those deaths. Even in the nations where HIV is most common, AIDS usually kills fewer babies than other diseases that can be treated using relatively inexpensive interventions, such as oral rehydration salts or antibiotics.
Every life is precious, and AIDS programs should not be shortchanged. But if the goal is saving young lives, there are other maladies that could be reduced dramatically with some low-tech investments. These include water treatment, nutrition programs and family-planning services, so mothers can control how many babies they bear. General medical care and sanitation go a long way toward creating healthy communities.
3. Mothers with HIV should never breast-feed.
A baby has a nearly 1 percent risk per month of contracting HIV from an infected mother who is breast-feeding, and many AIDS experts once believed that the risk of transmitting HIV during nursing made infant formula a better choice in almost all situations. That thinking has shifted in recent years with mounting evidence about the value of breast milk and the dangers of using formula in areas where clean water and a steady supply of formula aren’t reliably available.
A mother’s milk gives her baby essential nutrients and fluids — especially important in profoundly poor regions prone to drought — as well as antibodies that fight the diseases that are even more likely than AIDS to afflict babies. Infected mothers who live in developed countries are still urged not to breast-feed their babies. But where most of the world’s poorest babies are born and raised, forgoing mother’s milk can be more dangerous than the risk of contracting HIV during nursing.