JACKSON, Miss. Faith and compassion are guiding principles in the life of Dr. Hannah Gay, the University of Mississippi Medical Center pediatrician at the forefront of the reported cure of HIV in a 2-year-old girl born with the disease in rural Mississippi.
Gay and her husband Paul served as missionaries in the Horn of Africa 25 years ago as HIV was taking root there, but Gay's interest in the disease is driven more by a desire to achieve the best for children, rather than a desire to find a cure, her husband said.
"[Faith] influences every area of her practice. Hannah ministers through everything she touches. Her ministry is supported and guided by prayer," Paul Gay said. "The affection, the love that she has for the families and the children, the commitment she has, all [stem] from her faith. She has a dedication that flows from her relationship with God and I think that has attracted a team to work with her who share her commitment."
A longtime advocate of early antiretroviral intervention for babies born with HIV, Gay is being credited with achieving the "functional cure" of a baby born to an HIV-infected mother. Knowing the baby's high risk of being born with the disease, compounded by results of viral load tests, Gay began an aggressive treatment of the child 30 hours after birth and continued the therapy for the next 18 months.
Today, 10 months after the child's last therapy, she continues to test negative for HIV, according to research Gay and a team of doctors from Maryland and Massachusetts presented March 4 at the 20th Conference on Retroviruses and Opportunistic Infections in Atlanta.
The breakthrough is being hailed by the medical community as a functional cure that could lead to the elimination of HIV in children.
"In contrast to a sterilizing cure a complete eradication of all viral traces from the body a functional cure occurs when viral presence is so minimal it remains undetectable by standard clinical tests, yet discernible by ultrasensitive methods," UMMC said in a news release on its website.
The very private Gay is limiting media contact but in an interview with CNN, she said the full implications of the singular case are not clear.
"It will take a long time of studying and seeing if we can replicate this outcome in other babies before we can say yes, we've got a definite cure," Gay told CNN. "Until that point, all children, and adults for that matter, who are on good therapy and are controlling their [infection] need to stay on that therapy."
In an audio interview on UMMC's website, Gay said her work in Mississippi has been very fulfilling.
"We've been very successful at keeping the rate of transmission very low, and ... we're proud of that work and we continue to focus on prevention of HIV in children," Gay said.
During Gay's time as a missionary in the Horn of Africa, AIDS was becoming an epidemic there, her husband Paul told BP news from the couple's home near Jackson, Miss.
"There [were] just huge numbers coming out of Uganda and some frightening numbers coming out of Kenya about HIV. There was great work going on in Uganda to try to get some kind of handle on the massive problem. A third of the adult population in Uganda was infected with HIV back at that time," Paul Gay said.
In Ethiopia, the government denied there was a problem, he said.
"Although we could not document it, the rumor was that [in Ethiopia] people who contracted HIV disappeared. None of the nongovernmental organizations, none of the international organizations that were there in the country, did testing because we were afraid that a diagnosis would be a death sentence, not from the disease but from whoever was responsible for these disappearances," Paul Gay said. "So it was a silent problem. It was only after the fall of the communist government to the coalition of Eritrean and Tegrean forces in 1991 that people in authority began to speak."
Even then, he said, the government realized faith would play a role in the control of the disease.
"Their leadership said ... there is a component in stopping HIV that the government is not equipped to handle. The NGOs, the religious organizations will have to provide that component," he said. "While they weren't saying it openly, they were saying it very clearly that they recognized that there was a faith component, a moral component in stemming the growth and the tide of this disease. So that was an amazing disclosure by the authorities."
Gay's extensive work in pediatric HIV began after the couple returned to Mississippi. Already a pediatrician and wanting to secure part-time work in the field, she gained employment at UMMC's division of pediatric infectious diseases to help implement an early program to prevent transmission of HIV from mothers to newborns.
"Hannah came on with that in just a part-time position in what was considered a small program," her husband said, "and it just grew dramatically as knowledge about the nature of the disease, and how effective prevention could be grew. As the information grew and the need was recognized, Hannah's role and her job involvement grew.
"Her interest in HIV has always just stemmed from her love of children and her heart's desire to use her gifts to help as many as she could. When she found herself working in HIV, she did like she does in everything else. She threw herself fully into it and was determined to learn all she could to do the best she could for the children that came under her care. That's been the driver."