Very Early Antiretroviral Treatment of HIV-Positive Infants Slows Progression of Disease, Study Says
May 11, 2005
Administering antiretroviral treatment to very young, HIV-positive infants, especially when treatment starts before age three months, decreases the chance they will progress to the "advanced stage" of the disease by age three years, according to a study published in the May 11 issue of the Journal of the American Medical Association, Reuters Health reports. Dr. David Berk of the Stanford School of Medicine Division of Infectious Diseases and colleagues involved with the California Pediatric HIV Study Group examined the medical records of 205 HIV-positive infants born in Northern California between 1988 and 2001. Of the 205 children -- who were followed through age three -- about 65% received antiretroviral therapy and/or pneumonia prophylaxis, according to Reuters Health. By age three, 81 of the children had progressed to an AIDS diagnosis, and 41 of those children had died, according to Reuters Health (Gale, Reuters Health, 5/10). Untreated children were significantly more likely to progress to an advanced stage of disease, compared with children who received treatment. Overall, about 62% of untreated children studied progressed to an advanced stage of HIV, compared with 28% of treated children (Berk et al., JAMA, 5/11).
Any Treatment Beneficial
"Once our results were adjusted for age and year of calendar start, we found that older regimens -- those including one and two nucleoside reverse transcriptase inhibitors -- were associated with shorter time to first regimen switch," Brogly said. In addition, the researchers found that children who began treatment when they were severely immunocompromised had a shorter time to regimen switch. Brogly noted that patients who are exposed to more drug classes and specific drugs have a greater risk of developing drug resistance if the regimens are not taken properly, adding, "Switching could also result in a reduction of future treatment options" (Reuters Health, 5/10). In an accompanying editorial, Ram Yogev of Children's Memorial Hospital in Chicago writes, "While it is possible to celebrate the tremendous change in the outcomes of HIV-infected children treated with HAART, it is even more important to continue to prioritize research for the survivors who are now living with a chronic disease" (Yogev, JAMA, 5/11).
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This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.