HIV-infected infants benefit from immediate antiretroviral treatment

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Results from two National Institutes of Health (NIH)-funded studies presented Tuesday at the 19th Conference on Retroviruses and Opportunistic Infections underscore the importance of identifying and treating HIV-infected infants in the first year of life to protect their immune systems and to enable normal neurological development.

Jintanat Ananworanich, MD, PhD, presented findings from the PREDICT study, a clinical trial of HIV-infected children from Thailand and Cambodia examining when to start antiretroviral therapy (ART) in children that were not diagnosed in infancy and did not present for medical care until they became ill. The study of 299 children randomized half to receive immediate ART and delayed ART in the other half.  Both groups displayed relatively low rates of disease progression but neurological development problems were prevalent and frequent in both groups.  While ART in older children still has critical health benefits, it does not prevent or reverse neurological damage, according to the study authors.

Mark Cotton, MD, PhD, from Stellenbosch University in South Africa, presented study results that show that infants can safely stop ART after one to two years and still do much better than infants who are not placed on therapy until they get ill or show signs of a weakened immune system.  Very few infants who stopped treatment after one or two years of ART died or showed other signs of disease progression.  In a follow up of the study participants, 33 percent of infants that received two years of initial ART and 25 percent of those who received one year of ART were doing well and able to stay off treatment for about five years after the study ended.

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