HIV :: Early therapy slows HIV progression in babies

Very early treatment of babies infected with HIV — before age 3 months — is associated with better outcomes than when treatment is delayed, investigators report in this week’s Journal of the American Medical Association.

Dr. Yvonne A. Maldonado, at Stanford University School of Medicine and members of the California Pediatric HIV Study Group studied time trends in early progression of HIV infection among 205 children born between 1988 and 2001, using records of clinic visits through age 3.

About two-thirds of the children were given some form of antiretroviral therapy (ART). By age 3 years, 81 progressed to an advanced disease stage. Absence of treatment with ART was associated with increased risk of disease progression.

Among 23 children treated with three anti-HIV drugs, including either a drug called a protease inhibitor or another type called a nonnucleoside reverse transcriptase inhibitor, none progressed to the advanced stage.

The authors note that even ART with one or two drugs, if initiated by age 2 months versus 3 to 4 months, was associated with delayed and decreased progression to advanced stages.

“Because there are potential drawbacks of very early therapy…large, prospective clinical trials defining the differences between very early versus delayed institution of therapy are needed,” Maldonado’s group indicates.

These findings emphasize the need to test pregnant women for HIV to detect HIV-infected infants as soon as possible to maximize the benefits of early treatment, they add.


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