To save her sick child, an HIV-positive mother donated part of her liver. A world premiere which took place in 2017 in Johannesburg, South Africa, and which was successfully held. One year later, the child shows no signs of infection.
The medical team at the University of the Witwatersrand in Johannesburg waited a year to reveal this great world first to the general public. Thursday, October 4, an article published in the review AIDS tells us that last fall, an HIV negative child with liver disease underwent a transplant of a special kind.
It was his mother, who is a carrier of the HIV virus, who gave him this gift. HIV positive for several years, she was on triple therapy and therefore had an undetectable viral load. To save the child’s life, the medical team had no choice but to transplant part of his mother’s liver.
A high risk of HIV transmission
According to France Info, the child had been awaiting a liver transplant for 6 months and saw his state of health deteriorate. Hospitalized several times, his vital prognosis was engaged each time. In the absence of a compatible donor, the mother of the child thus offered to donate part of his liver to him.
But it was not without risk. Indeed, without a detectable viral load, an HIV-positive person cannot transmit the virus to a sexual partner. But this is not the case with an organ transplant, during which virus reservoir cells can be transmitted to the recipient. But even if the operation presented “risks of HIV transmission for the recipient”, the medical team made the decision to perform the transplant due to “exceptional circumstances”. “Without a transplant, the child would certainly have died,” the University of the Witwatersrand said in a statement.
Faced with the high risk of contamination, the medical team however expected the worst. “In the weeks following the transplant, we thought the child was HIV positive,” admits surgeon Jean Botha. A retroviral treatment was prescribed to the child before the transplant and it seems to have worked: to date, he shows no signs of infection. He is still taking preventive HIV treatment.
New potential organ donors
For the doctor, the retroviral treatment “could have prevented the contamination by the HIV. We will only know that definitively with time.”
Indeed, the risk is that the virus will manifest itself in the body within a few months or years, as was the case in 2014. Born HIV-positive in 2010, an American girl had received within 30 hours of her birth. birth intensive treatment with antiretrovirals for 18 months. The subsequent blood tests did not detect the presence of HIV. Without speaking of cure – the virus not having disappeared completely -, the doctors had then opened the promising track of an ultra-early treatment. But in July 2014, researchers announced that the virus had reappeared in the little girl, then 4 years old.
For the doctors who performed the transplant from an HIV-positive adult with an undetectable viral load, this “world first” nevertheless remains a success. According to them, it offers new perspectives for patients who are desperate for an organ. “It presents a new pool of living donors that could save lives,” say the researchers.
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