Skip to main content

Prevention can mean no babies with HIV

By Mary Guinan, Special to CNN
updated 8:34 AM EST, Wed March 6, 2013
A girl, 1 hour old, receives an anti-retroviral drug in South Africa to prevent infection from the HIV virus carried by her mother.
A girl, 1 hour old, receives an anti-retroviral drug in South Africa to prevent infection from the HIV virus carried by her mother.
STORY HIGHLIGHTS
  • Mary Guinan one of the first to investigate AIDS, treated patients from 1981-1998
  • She has seen the progress of AIDS as a death sentence to people living with HIV
  • Guinan: Baby cured of HIV infection is great news, but infant didn't have to be infected
  • She says anti-retroviral drugs can easily prevent transmission from mother to child

Editor's note: Mary Guinan is a physician and former associate director for science at the Centers for Disease Control and Prevention. She was a member of the first CDC Task Force to investigate and identify the AIDS epidemic. That story is told in the book and movie "And the Band Played On." In 1998, she became Nevada state health officer and in 2004, became the founding dean of the University of Nevada-Las Vegas School of Public Health, renamed the School of Community Health Sciences.

(CNN) -- I took care of AIDS patients from 1981 to 1998 in a county clinic in Atlanta. By the time they showed up at the door, many of them had advanced disease. Most died within two years. Before they died, they suffered from untold painful physical conditions in addition to the unique brand of pain caused by the the pervasive social stigma of AIDS.

Without effective treatment of HIV, a physician couldn't offer much more than supportive care. Then, in 1995, a "cocktail" of three anti-retroviral drugs proved to be successful in fighting the virus -- not completely killing it, but reducing its numbers so its devastation of the immune system was minimized.

The treatment worked like a miracle. Patients got better and very quickly. Seeing the transformation of patients from close to death's door to living healthy lives was one of the most rewarding experiences I've had as a physician.

Dr. Mary Guinan
Dr. Mary Guinan
Become a fan of CNNOpinion
Stay up to date on the latest opinion, analysis and conversations through social media. Join us at Facebook/CNNOpinion and follow us @CNNOpinion on Twitter. We welcome your ideas and comments.



But the patients aren't cured. They must take drugs for their lifetime. Neither a cure for HIV nor a vaccine to prevent HIV has yet been developed.

Now, an HIV-infected baby who was treated with a combination of drugs from birth to 18 months and then not treated for a year was found to be free of HIV infection at 30 months. The child is considered cured.

This is the second reported HIV cure in history and the first in a child, and it is rightly making international news. We can all share the joy of a child cured and hope the treatment will bring a better life for infected babies in the future. Kudos to the clinician, Dr. Hannah B. Gay, whose expertise, instincts and treatment of the infant led to this remarkable outcome.

But there was another great advance against the HIV virus that did not make big headlines. A simple treatment with anti-retroviral drugs can prevent babies from being infected by their HIV positive mothers in the first place. Of course, a patient cure is much more visible than an infection prevented. Maybe that is why we celebrate cure in a way that we do not celebrate prevention.

Toddler's HIV cure offers global hope

Until the mid-1990s, pregnant women with HIV infection had a 30% chance of transmitting the infection to their newborn. A landmark study showed that treating HIV-positive pregnant women during their labor and delivery with intravenous zidovudine, or AZT, and then giving the infant AZT syrup orally for four to six weeks reduced the risk of HIV transmission to less than 2%. Successful prevention means the baby is free of HIV infection and will no longer need treatment.

We should also celebrate those babies who were not infected with HIV by virtue of treatment of mother and newborn with this drug regimen. Kudos to the thousands of clinicians who have treated HIV-infected pregnant mothers and their offspring.

Baby cured of HIV
Baby "cured" of HIV, are adults next?

How do we know the treatment was effective? We know only by the data meticulously collected by the Centers for Disease Control and Protection since AIDS was first recognized in 1981.

HIV transmission from mother to child during pregnancy, labor and delivery or breastfeeding is known as perinatal transmission. In 2012, the CDC reported that the combined mother/infant HIV treatment regimen resulted in a decline of perinatal transmission by more than 90% since the beginning of the HIV/AIDS epidemic.

AIDS in the '90s: 'I wasn't going to die miserably'

This incredible reduction was accomplished despite the fact that more women with HIV infection were giving birth. How far we have come.

Women with health care do not have a problem being tested for HIV. The problem lies with women who don't have health care and have not been tested. In 2005, the CDC recommended that if a women arrives in labor in the emergency room and has not had prenatal care, a rapid, 20-minute test for HIV should be done so preventive treatment can be started immediately.

Despite the existence of this treatment, babies are still born infected with HIV in the United States and worldwide. Prevention strategies are rarely perfect. That is why we need to have a Plan B for babies with HIV infection -- and the findings of Gay and her colleagues might be just that. The potential impact of this discovery will be far greater in developing countries -- especially in Africa, where thousands of HIV-infected babies are born each year.

Of course, what we desperately need to control HIV is a safe and effective vaccine for both infants and adults. Until then, let us celebrate each success. Each one gives hope that we will eventually conquer one of the most formidable of viruses.

Follow @CNNOpinion on Twitter.

Join us at Facebook/CNNOpinion.

The opinions expressed in this commentary are solely those of Mary Guinan.

ADVERTISEMENT
Part of complete coverage on
updated 3:18 PM EDT, Thu April 24, 2014
Frida Ghitis says as violence claims three U.S. doctors, the temptation is to despair, but aid to Afghanistan has made it a much better place
updated 2:33 PM EDT, Thu April 24, 2014
Ruben Navarrette says in California, Asian-Americans are against the use of racial criteria in public colleges.
updated 2:44 PM EDT, Thu April 24, 2014
Heidi Schlumpf says if the Pope did tell an Argentinian woman married to a divorced man that she could take Communion, it may signify a softening of church rules on the divorced and sacraments
updated 12:29 PM EDT, Thu April 24, 2014
Norcross, Georgia, Chief of Police Warren Summers says the new law that allows guns in bars, churches and schools will have unintended dangerous consequences.
updated 1:42 PM EDT, Thu April 24, 2014
Mel Robbins says social media is often ruled by haters, and people can be brutally honest.
updated 12:44 PM EDT, Thu April 24, 2014
Mike Downey says the golf purists can take a hike; the game needs radical changes to win back fans and players.
updated 12:41 PM EDT, Wed April 23, 2014
Robert Hickey says most new housing development is high-end, catering to high-earners.
updated 9:17 AM EDT, Wed April 23, 2014
Alexander Motyl says as Russian President Putin snarled at Ukraine, his foreign minister was signing a conciliatory accord with the West. Whatever the game, the accord is a major stand down by Russia
updated 8:29 AM EDT, Wed April 23, 2014
Les Abend says at every turn, the stowaway teen defied the odds of discovery and survival. What pilot would have thought to look for a person in the wheel well?
updated 7:04 AM EDT, Thu April 24, 2014
Q & A with artist Rachel Sussman on her new book of photographs, "The Oldest Living Things in the World."
updated 3:58 PM EDT, Tue April 22, 2014
Martin Blaser says the overuse of antibiotics threatens to deplete our bodies of "good" microbes, leaving us vulnerable to an unstoppable plague--an "antibiotic winter"
updated 1:37 PM EDT, Tue April 22, 2014
John Sutter asks: Is it possible to eat meat in modern-day America and consider yourself an environmentalist without being a hypocrite?
updated 11:38 AM EDT, Tue April 22, 2014
Sally Kohn notes that Meb Keflezighi rightly was called an American after he won the Boston Marathon, but his status in the U.S. once was questioned
updated 8:56 AM EDT, Tue April 22, 2014
Denis Hayes and Scott Denman say on this Earth Day, the dawn of the Solar Age is already upon us and the Atomic Age of nuclear power is in decline
updated 4:36 PM EDT, Mon April 21, 2014
Retired Coast Guard officer James Loy says a ship captain bears huge responsibility.
updated 1:08 PM EDT, Mon April 21, 2014
Peter Bergen says the latest strikes are part of an aggressive U.S. effort to target militants, including a bomb maker
updated 9:45 AM EDT, Mon April 21, 2014
Cynthia Lummis and Peter Welch say 16 agencies carry out national intelligence, and their budgets are top secret. We need to know how they are spending our money.
updated 8:35 AM EDT, Mon April 21, 2014
Julian Zelizer says President Obama knows more than anyone that he has much at stake in the midterm elections.
updated 8:55 AM EDT, Tue April 22, 2014
Eric Sanderson says if you really want to strike a blow for the environment--and your health--this Earth Day, work to get cars out of cities and create transportation alternatives
updated 10:08 AM EDT, Mon April 21, 2014
Bruce Barcott looks at the dramatic differences in marijuana laws in Colorado and Louisiana
updated 4:47 PM EDT, Fri April 18, 2014
Jim Bell says NASA's latest discovery supports the notion that habitable worlds are probably common in the galaxy.
updated 2:17 PM EDT, Fri April 18, 2014
Jay Parini says even the Gospels skip the actual Resurrection and are sketchy on the appearances that followed.
updated 1:52 PM EDT, Fri April 18, 2014
Graham Allison says if an unchecked and emboldened Russia foments conflict in a nation like Latvia, a NATO member, the West would have to defend it.
updated 9:11 AM EDT, Fri April 18, 2014
John Sutter: Bad news, guys -- the pangolin we adopted is missing.
updated 2:25 PM EDT, Mon April 21, 2014
Ben Wildavsky says we need a better way to determine whether colleges are turning out graduates with superior education and abilities.
updated 6:26 AM EDT, Fri April 18, 2014
Charles Maclin, program manager working on the search and recovery of Malaysia Flight 370, explains how it works.
updated 8:50 AM EDT, Fri April 18, 2014
Jill Koyama says Michael Bloomberg is right to tackle gun violence, but we need to go beyond piecemeal state legislation.
updated 2:45 PM EDT, Thu April 17, 2014
Michael Bloomberg and Shannon Watts say Americans are ready for sensible gun laws, but politicians are cowed by the NRA. Everytown for Gun Safety will prove the NRA is not that powerful.
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT