The doctors decided that it was worth the risk of exposing the child to HIV.
“The transplant team faced the dilemma of saving the child’s life whilst at the same time knowing that the child might end up HIV-positive because of this decision,” experts at the University of the Witwatersrand, who wrote about the case in the journal AIDS, said, according to the Associated Press.
Both the mother and child have recovered from the 2017 transplant, but do not yet know if the child contracted HIV, reported the transplant team at the Wits Donald Gordon Medical Centre in Johannesburg. They gave the child medication to prevent the transfer of HIV before the transplant, but it will take time to see if it worked.
With a lack of non-HIV-infected livers available for donation, the mother asked her doctors if she could give part of hers as a living transplant. She was taking antiretroviral drugs to target her HIV, but they said there was a significant risk to the child.
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After the transplant, they thought the child may have contracted HIV, “because we detected HIV antibodies,” the transplant surgeon, Jean Botha, said. But further testing came up negative.
If the child does develop HIV, he would be able to “lead a relatively normal life” thanks to improved medications, Dr. Anthony Fauci, infectious diseases chief at the U.S. National Institutes of Health and a leading HIV expert, told the Associated Press. The child would need just one pill a day to protect themselves, he said.
“If it is a choice between death and living reasonably well with a treatable infection, I think they made a quite reasonable choice,” Fauci said, but added that this isn’t true for all patients. “Everything has to be on a case-by-case-basis.”