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Girl hoped to have been cured of HIV has relapsed

By WTOP Staff

MARILYNN MARCHIONE
AP Chief Medical Writer

A Mississippi girl born with the AIDS virus and in remission for more than two years despite stopping treatment now shows signs that she still harbors HIV — and therefore is not cured. The news is a setback to hopes that very early treatment with powerful HIV drugs might reverse an infection that has seemed permanent once it takes hold.

The girl is now nearly 4. As recently as March, doctors had said that she seemed free of HIV though she was not being treated with AIDS drugs. That was a medical first.

But on Thursday, doctors said they were surprised last week to find the virus in her blood, and there were signs that it was harming her immune system. She is now back on treatment and is responding well, they said.

The news is “obviously disappointing” and will affect a federal study that had been about to start testing early, aggressive treatment in such cases, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Doctors had been considering stopping treatment if no signs of infection could be detected after two years.

“We’re going to take a good hard look at the study and see if it needs any modifications,” either in terms of length of treatment or because of ethical concerns over raising false hopes about an approach that now has suffered a setback, Fauci said. At a minimum, consent forms to join the study must be revised, he said.

Most HIV-infected moms in the U.S. get AIDS medicines during pregnancy, which greatly cuts the chances they will pass the virus to their babies. The Mississippi baby’s mom received no prenatal care and her HIV was discovered during labor. Because of the baby’s great risk of infection, doctors started her on unusually powerful treatment 30 hours after birth, even before tests could determine whether she was indeed infected.

The girl was treated until she was 18 months old, when doctors lost contact with her. Ten months later when she returned, they could find no sign of infection even though the mom had stopped giving her AIDS medicines.

Tests repeatedly showed no detectable HIV until last week, when copies of the virus were measured in her blood. Doctors say they don’t know why the virus rebounded when it did, and said it raises profound questions about what they know about HIV’s hideouts in the body.

“We are still very much in the early discovery phase of trying to achieve a sustained virological remission and perhaps even a cure. There is much, much more to learn and we remain committed to doing so,” Fauci said.

The girl’s experience still suggests that early, aggressive treatment can limit the size of the reservoir of dormant virus in the body and help control infection, said one specialist involved in the case, Dr. Deborah Persaud of Johns Hopkins Children’s Center in Baltimore.

“What we’ve learned from this case is really quite amazing,” said Jeffrey Safrit, research chief at the Elizabeth Glaser Pediatric AIDS Foundation. “They were able to suppress virus for a very long time without therapy. We need to take the positive aspects of this case and learn from them to move forward” with the federal study, he said.

In March, doctors revealed that a second baby born with HIV may have had her infection put into remission by very early treatment — in this case, four hours after her birth in suburban Los Angeles in April 2013. Nearly a year later, very sophisticated tests at multiple times suggested she had completely cleared the virus, but she remains on treatment so there is no way to know for sure.

Only one other person is thought to have been cured of HIV infection — a San Francisco man who had a bone marrow transplant in 2007 from a donor with natural resistance to HIV. He showed no sign of infection more than five years later.

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Online:

AIDS information: http://www.aidsinfo.nih.gov

and http://www3.niaid.nih.gov/topics/HIVAIDS/

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Don’t Settle for Student Loans to Pay for Online Education

By WTOP Staff
Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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