The case for earlier and wider initiation of antiretroviral therapy just keeps getting stronger.
First, there’s the increasing solid consensus that initiating ART earlier significantly increases an HIV patient’s chances of survival. Then there’s the fact that initiating ART earlier reduces the number of people needing more costly second-line therapy. We also know that the best way to stave off tuberculosis-related deaths in HIV-positive individuals is to put those patients on ART.
Add to all that this latest news: New mothers receiving highly active antiretroviral therapy (HAART) for HIV-1 infection are much less likely than untreated mothers to transmit the virus to their newborns through breastfeeding. Those findings, published online today in the Nov. 15 issue of The Journal of Infectious Diseases, suggest HAART regimens should be initiated “as early as possible in eligible mothers in areas with limited resources, such as Africa, where most infant HIV-1 infections occur, and breastfeeding is common,” according to a news release from JID.
The study, conducted in mother/infant pairs in Malawi and led by Taha E. Taha, MBBS, PhD, of Johns Hopkins University Bloomberg School of Public Health, found that HAART was associated with an 82 percent reduction in postnatal HIV-1 transmission.
“While acknowledging more research is needed to develop safe, effective, and affordable ways to prevent postnatal transmission in settings with few resources, the study’s authors recommend that women presenting late in pregnancy who have low CD4 counts and require antiretroviral treatment start HAART as soon as possible during pregnancy or postpartum,” the JID news release says.
In an accompanying editorial, Grace C. John-Stewart, MD, PhD, of the University of Washington School of Public Health, writes of the need “accelerate many incremental steps” to make PMCTC programs more successful.
“As research informs new PMTCT policy recommendations, it is critical to improve the logistics of CD4 cell count testing and HAART integration to increase the effectiveness of PMTCT and lay the foundation for even more effective programs,” he writes.