By Dustin Lee and Emily Le Coz, The (Jackson, MS) Clarion-Ledger
JACKSON, Miss. -- As the dust settles around the global news of an HIV cure that worked for a Mississippi infant, the effect of the announcement remains to be seen in a state with one of the nation's worst outcomes for people with the virus that causes AIDS.
New cases and prevalence of HIV in Mississippi rank among the highest in the nation, said Deborah Konkle-Parker, an associate professor in the University of Mississippi Medical Center's division of infectious diseases.
"It's actually quite bad in Mississippi," she said, adding the Jackson metro area ranks third in the country for most new incidences of HIV and for highest prevalence.
"Of people who have HIV, Mississippi has the worst outcomes," Konkle-Parker said. "Of the people who are affected, we're doing the least work of keeping them alive."
Part of the problem comes from the stigma attached to HIV, which can stop many from seeking treatment, Konkle-Parker said. And the mostly rural settings of the state hinder access to care.
An HIV-positive mother from rural Mississippi gave birth to the girl who would go down in history as only the second person to have been cured of the virus.
Konkle-Parker's colleague, UMC pediatric HIV specialist Dr. Hannah Gay, treated the child 30 hours after birth.
"It was a high-risk case," Gay said. "I suspected more strongly that this baby could be infected than I would if the mom had been treated during pregnancy."
Gay said she began treatment with three drugs, a more intense measure than normal.
"We drew tests on the baby just as we were starting those medicines, and they showed us the baby already was infected," she said. "Infection probably occurred just before delivery.
"When we consider starting any medicine in any patient, we always consider the risk-benefit ratio, and when the risk is something as serious as HIV disease, then it's worth the benefit you may get from preventing that disease," Gay had said during a news conference Monday night. "So even though you never want to start drugs that may cause toxicities, if the benefit outweighs the risk, you do it."
The girl -- whom Gay and her team lost touch with for about five months -- responded better than expected. After her return to treatment, they discovered she didn't have the active virus in her system.
"In the developing world, this is huge," said Konkle-Parker, who noted the instances of babies contracting HIV in the womb is a major problem. "In the United States, it's much more of an adult illness."
In Mississippi, an average of 588 people contract HIV each year, according to state Department of Health records.
"I have Mississippi that I am specifically concerned over," Gay said Tuesday. "In the United States, there are now only about 200 transmissions a year from mother to baby. Before preventive measures of treating the mom, we were looking at over 2,000 transmissions per year in the United States.
"In Mississippi, we've had less than 1% transmission over a number of years now," Gay said. "Of course, we'd like to see zero transmission, and most years we've achieved that."
While Gay said the media attention has been overwhelming, she is glad this case continues to receive attention.
"But I guess the message that I want to get across to the public very strongly is we don't know yet if we can create the same outcome in other babies."
Konkle-Parker remained cautiously optimistic, saying the next step is to see the outcome replicated.
"But what I hope will come of this, and it may take a long time, but I hope it will point us in the right direction to come up with a cure we can consistently apply to other babies worldwide."