Early Testing, Treatment Can Prevent Illness, Death In HIV-Positive Babies

by VR Sreeraman on Nov 22 2008 2:26 PM

A new study has revealed that testing very young babies for HIV and giving antiretroviral therapy (ART) immediately to those found infected with the virus dramatically prevents illness and death.

Launched in South Africa in July 2005, 'Children with HIV Early Antiretroviral Therapy' (CHER) study is sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and the departments of health of the Western Cape and Gauteng in South Africa.

The study, led by Avy Violari, FCPaed, and Mark F. Cotton, MMed PhD, found that giving ART to HIV-infected infants beginning at an average age of 7 weeks made them four times less likely to die in the next 48 weeks, compared with postponing ART until signs of illness or a weakened immune system appeared-the standard of care when the study began.

"HIV devastates the nascent immune systems of infants very quickly, yet too many HIV-infected infants do not get tested for the virus, get tested too late or get tested but lack access to lifesaving antiretroviral drugs," said Anthony S. Fauci, M.D., the director of NIAID.

"The results of CHER are a clarion call to scale up widespread early HIV testing of at-risk infants and to make ART immediately accessible to all infants who test positive," he added.

This finding helped influence the World Health Organization (WHO) to change its guidelines for treating HIV-infected infants.

The new guidelines, issued in April 2008, suggested that starting ART in children under age 1 immediately after HIV diagnosis, regardless of their state of health. An NIAID study to identify the best drug regimen for these highly vulnerable children is under way.

Ed Handelsman, M.D., chief of the Pediatric Medicine Branch in NIAID's Division of AIDS, said: "The new WHO guidelines will profoundly improve the survival rate and quality of life of infants born with HIV."

"We are excited that we know the best time to begin treating HIV-infected infants; the challenge now for the global community is to ensure that all HIV-infected infants who need ART receive it soon enough," Handelsman added.

The study is published in the New England Journal of Medicine.