News from Lifespan

“Healthy Beginnings” Study Promotes Healthy Eating, Exercise During Pregnancy

Wed, 22 May 2013 00:00:00 EDT

Researchers from The Miriam Hospital are looking at ways to help expecting moms gain a healthy amount of weight during pregnancy

The Miriam Hospital Honored wins National Health Care Environmental “Partnership” Award

Mon, 20 May 2013 00:00:00 EDT

Award recognizes Miriam’s Greenways team of environmental champions

Miriam Researchers Explore Link between Obesity, Depression and Weight Loss

Wed, 15 May 2013 00:00:00 EDT

Little is known about how people with major depressive disorder respond to behavioral weight loss treatment.

Three Lifespan Nurses Honored by Rhode Island State Nurses Association

Wed, 8 May 2013 00:00:00 EDT

Sylvia Weber, Marc Kalapos and Nancy Robin recognized for nursing excellence; Nurses Week is May 6-12, 2013

Lynn E. Taylor, MD, Receives Prestigious 2013 Rhode Island Foundation Innovation Fellowship

Thu, 18 Apr 2013 00:00:00 EDT

Lynn E. Taylor, M.D., an HIV and viral hepatitis specialist at The Miriam Hospital, is one of two recipients of the 2013 Rhode Island Innovation Fellowship.

Join Us for a Live Chat on Twitter About How Online Tools Can Help You Lose Weight and Stay Fit

Wed, 17 Apr 2013 00:00:00 EDT

J. Graham Thomas, Phd., a research psychologist with The Miriam Hospital’s Weight Control and Diabetes Research Center, will be on Twitter to share tips on the ways technology helps you lose weight.

Texting, Social Networking and Other Media Use Linked to Poor Academic Performance

Thu, 11 Apr 2013 00:00:00 EDT

Miriam Hospital researchers say college women spend a significant amount of time using media during their freshmen year, which can lead to lower GPAs

Forced Methadone Withdrawal in Jails Creates Barrier to Treatment in Community

Wed, 27 Mar 2013 00:00:00 EDT

Miriam researchers say correctional policies discourage released inmates from seeking methadone therapy

Can A Smartphone App Encourage You To Be More Active? Miriam Hospital Researchers Want To Know

Tue, 26 Mar 2013 00:00:00 EDT

Researchers at The Miriam Hospital are launching a new study, known as B-MOBILE.

Miriam Study Reveals Financial Benefits of a Plant-based, Mediterranean Diet

Wed, 20 Mar 2013 00:00:00 EDT

Adopting plant-based meals several times per week can improve food security, lower food costs for food pantry clients

Lifespan Takes Major Step to Transform Health Care Delivery

Tue, 19 Mar 2013 00:00:00 EDT

Selects Epic Systems technology platform for its patient-centric approach

Aadia Rana, MD Offers Insights on Baby Cured of HIV

Mon, 11 Mar 2013 00:00:00 EDT

Aadia Rana, MD

The news continues to make international headlines: A Mississippi baby born with HIV has apparently been cured of the disease. Aadia Rana, MD, an infectious disease specialist at The Miriam Hospital, collaborates with the pediatric HIV specialist who treated the child on research involving linkage and retention in care among postpartum women in Mississippi. She offers her insight on this remarkable medical breakthrough.

The child’s mother, who is also HIV-positive, did not receive any prenatal care, and doctors were only made aware of her disease status when she arrived at the hospital in labor. Because she was so close to delivering, she did not even receive a dose of medication that is routinely given to HIV-infected mothers to help reduce the risk of transmission to the infant. What happened next?

My colleague at the University of Mississippi Medical Center, Dr. Hannah Gay, quickly started the baby on full anti-HIV medications within the first 30 hours of her birth. The infant was found to have the virus in her blood several times, but after being on therapy for several weeks, there was no evidence of the virus in her blood as is expected to happen for someone on treatment. Unfortunately, when the baby was about 18 months old, the mother stopped bringing the infant to her appointments. They tracked her down five months later and discovered the child’s HIV blood test showed no evidence of the virus! Dr. Gay involved researchers at the University of Massachusetts and Johns Hopkins and the tests were repeated using very sensitive methods, and they did not find any actively reproducing virus.

When researchers say the child is "cured," what does that mean exactly?

The researchers are terming this case a ‘functional cure.’ This definition is used when standard tests are negative for the virus, but it is likely that a tiny amount remains in their body though there is no evidence it is actively reproducing at this time. This is the case with this child, even though she has been off of medicine for more than one year now.

Why did this happen?

We are not exactly sure why, but one of the theories is that the child received therapy with full anti-HIV medications – three medications instead of one – very quickly after the virus was introduced into her blood, and the drugs eliminated the virus before it could infect ‘deeper’ cells that function as hideouts for the virus. This is why adults and older children aren't cured of HIV even when they are taking anti-HIV medications – there is still evidence of the virus in these hideout cells.

Could this be a game changer when it comes to treating infants born to HIV-infected mothers?

I think this case brings up some important questions regarding treatment of possible HIV infection in the early stages, particularly with regard to an infant’s immune system. Children infected with HIV are given drugs with the intent to treat them for life, and anyone who takes the drugs must remain on them. It is far too early and there are still too many unanswered questions for anyone to try stopping therapy just to see if the virus comes back.
The most reliable way to stop babies from contracting the virus from infected mothers is by identifying and treating HIV-positive women. In the U.S., these strategies prevent 98 percent of newborn infections. It is the women who are not identified as HIV-infected or do not receive therapy who are at highest risk for transmitting the virus to their baby – like in this case.

What are the next steps in this line of research?

Currently, when an infant is presumed infected with HIV, the plan is to give the child lifelong medications to keep the virus under control. With this case, the next step would be to find out if this was an unusual response to very early HIV therapy, or a finding that can actually be shown in other high-risk newborns. If that is the case, there may be opportunities for functional cure in other infants who are treated with full anti-HIV therapy very early one.

How does this case relate to your area of research?

My research focuses on improving engagement with medical care among pregnant and postpartum HIV-infected women in the South, which is significantly impacted by the HIV epidemic. I have been collaborating with clinicians, including Dr. Hannah Gay and Dr. Binford Nash at the University of Mississippi Medical Center, to better understand the barriers to care among these women. I think another key message in this case is that the child was out of care for five months, at which time she did not receive any of the medical treatment she may have needed. Her mother did not receive any prenatal, and given the story, probably did not obtain medical care after her delivery either. These are very salient issues that continue to drive the HIV epidemic in this country.

Lifespan Emergency Physicians Join with Brown University Leaders to Improve Humanitarian Aid Efforts

Thu, 7 Mar 2013 00:00:00 EST

Preparing responders for international crises is crucial for protecting lives

Eating Healthy on a Shoestring Budget

Wed, 6 Mar 2013 00:00:00 EST

March is National Nutrition Month

HIV Therapy Just Got Easier: Fewer Drugs May Be Needed For Treatment-Experienced Patients

Tue, 5 Mar 2013 00:00:00 EST

Multi-site study, led by a Miriam researcher, could change treatment strategy for these patients