CROI 2014: HIV in mothers, infants continues to challenge health, survival

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CROI2014BOSTON, MASS – On the day that brought an update on the Mississippi baby, who remains free of HIV infection two years after antiretroviral treatment was discontinued, and another baby who tests HIV-negative while continuing early aggressive treatment, CROI presentations also highlighted the challenges HIV presents to birth and survival for mothers and their infants.

In 2012, a presenter Tuesday noted, 260,000 children became infected with HIV and 210,000 died as a result of HIV, while 3.3 million children live with the virus.

These figures topped off a presentation of otherwise promising data, indicating that when the kind of early combination antiretroviral treatment the Mississippi baby, and now the “Long Beach baby,” got in the first hours of their lives has been started on infants within the first few months of life, it is not only safe, but preserves immune function, is linked to a marked decrease in death rates, and fosters long-term control of HIV replication.

Without treatment, children experience much faster disease progression than adults, Dr. Katherine Luzuriaga, who presented the data, noted. As data has shown previously, including once again, here at CROI, the treatment gap between children and adults has only widened, as efforts to accelerate provision of antiretroviral medicine access in the last two years has continued to reach adults first.

At the same time, in spite of the availability of antiretroviral medicine, HIV-related infections remain a leading cause of maternal deaths in South Africa, where a 15-year study reviewed mortalities among pregnant women from 1997 to 2012. The availability of antiretroviral medicine is not enough, and with more than 80 percent of deaths taking place after childbirth, post-partum care is critical, and insufficient, presenter Coceka N. Mnyani said.



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