Doctors Call for Antibiotic Drug for HIV Children

All HIV-infected children in developing countries should be treated with a low-cost antibiotic to reduce deaths by preventing opportunistic infections such as pneumonia or TB, Dr. Diana Gibb of Britain's Medical Research Council said today. In a study, researchers gave HIV-positive children in Zambia a daily dose of the antibiotic co-trimoxazole, which nearly halved the death rate in those taking the drug compared to those who were given a placebo. The study was stopped early because it was so successful.

"We believe that our results can be generalized to a policy that could be applied universally to children with clinical features of HIV infection in Africa and elsewhere," said Gibb, adding that she and her team believe children should receive co-trimoxazole regardless of their age or CD4 count.

In the study, researchers tested the drug in a trial involving 541 HIV-infected children ages 1-14 in Zambia. The children were randomly selected to receive co-trimoxazole or a placebo. Study follow-up was 19 months. Twenty-eight percent of the children in the drug group died, compared to 42 percent in the control group.

"Co-trimoxazole in resource-limited settings where there are a lot of infections for children is certainly something that could have an impact on their quality of life, hospital admissions and mortality," Gibb said.

The drug would cost about $10 a year for each child, said Gibb. "Nutritional support and co-trimoxazole could definitely have an impact while waiting to see if antiretrovirals can be rolled out," she added.

The study, "Co-Trimoxazole as Prophylaxis Against Opportunistic Infections in HIV-Infected Zambian Children (CHAP): a Double-Blind Randomised Placebo-Controlled Trial," was published in The Lancet (2004;364(9948):1865-1871).

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