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The mother and the child have recovered after the transplant of 2017, but it is not yet known if the child is carrying the virus that causes AIDS,
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JOHANNESBURG – South African doctors say they grafted part of the liver of an HIV-positive mother to her seriously ill but seronegative child, concluding that the chances of saving a life exceeded the risk of transmitting the virus.
The mother and the child have recovered after the transplant in 2017, but it is not yet known if the child is carrying the virus that causes AIDS, according to the Wits Donald Gordon Medical Center team. Johannesburg.
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The experts at the University of the Witwatersrand explained the procedure in an article published Thursday in the journal AIDS. Drugs provided to the child before the transplant may have prevented the transmission of HIV, although this only becomes clear over time, they said. The liver of a donor not infected with HIV was not available in a country where there is a chronic shortage of organs available for transplantation.
"The transplant team faced the dilemma of saving the child's life knowing that the child could become HIV positive because of this decision," said the university.
The mother, who was taking antiretrovirals to fight HIV, had asked her if she could donate part of her liver to save her child's life, and the medical team explained the risks to her. from a "living liver donation", according to the university. The organ is able to regenerate and become complete again.
"In the weeks following the transplant, we thought that the child was HIV-positive because we detected HIV antibodies," surgeon-transplantist Jean Botha said in a statement. However, more tests done by HIV experts at the National Institute of Communicable Diseases of South Africa have not found active HIV infection in the US. 39; child.
South Africa has the largest antiretroviral treatment program in the world, improving the lives of many people living with HIV.
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Doctors had to consider that with the current improved HIV medications, the child could "lead a relatively normal life" with one pill a day, even if he was infected, according to Dr. Anthony. Fauci, head of infectious diseases at US National. Institutes of Health and a leading expert on HIV.
"If it's a choice between death and a reasonably good life with a treatable infection, I think they've made a perfectly reasonable choice," he said.
But Fauci pointed out that a case does not mean that the approach is ready to be tried again: "Everything must be done on a case by case basis."
In some cases, HIV-infected organs have been unintentionally transplanted to seronegative patients. And in the United States, Johns Hopkins University has in recent years been a pioneer in the transplantation of HIV-positive transplant donors.
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