Featured Research

from universities, journals, and other organizations

Benefits Of Early HIV Testing And Treatment For Infected Infants Defined

Date:
December 4, 2008
Source:
NIH/National Institute of Allergy and Infectious Diseases
Summary:
Testing very young babies for HIV and giving antiretroviral therapy immediately to those found infected with the virus dramatically prevents illness and death, according to a report in the New England Journal of Medicine.

Testing very young babies for HIV and giving antiretroviral therapy (ART) immediately to those found infected with the virus dramatically prevents illness and death, according to a report in the New England Journal of Medicine.

Related Articles


The study found that giving ART to HIV-infected infants beginning at an average age of 7 weeks made them four times less likely to die in the next 48 weeks, compared with postponing ART until signs of illness or a weakened immune system appeared--the standard of care when the study began.

These findings come from the "Children with HIV Early Antiretroviral Therapy" (CHER) study, the first Phase III randomized clinical trial to study the best time to begin ART in infants. Launched in South Africa in July 2005, CHER is sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and the departments of health of the Western Cape and Gauteng in South Africa.

"HIV devastates the nascent immune systems of infants very quickly, yet too many HIV-infected infants do not get tested for the virus, get tested too late or get tested but lack access to lifesaving antiretroviral drugs," says Anthony S. Fauci, M.D., the director of NIAID. "The results of CHER are a clarion call to scale up widespread early HIV testing of at-risk infants and to make ART immediately accessible to all infants who test positive."

Preliminary results of CHER, released in July 2007, showed that HIV-infected infants were four times less likely to die if given ART immediately after HIV diagnosis. This finding helped influence the World Health Organization (WHO) to change its guidelines for treating HIV-infected infants. The new guidelines, issued in April 2008, strongly recommend starting ART in children under age 1 immediately after HIV diagnosis, regardless of their state of health. An NIAID study to identify the best drug regimen for these highly vulnerable children is under way.

"The new WHO guidelines will profoundly improve the survival rate and quality of life of infants born with HIV," says Ed Handelsman, M.D., chief of the Pediatric Medicine Branch in NIAID's Division of AIDS. "We are excited that we know the best time to begin treating HIV-infected infants; the challenge now for the global community is to ensure that all HIV-infected infants who need ART receive it soon enough."

The CHER study team, lead by Avy Violari, FCPaed, and Mark F. Cotton, MMed PhD, recruited and enrolled 377 infants between 6 and 12 weeks of age who had confirmed HIV infection but normal immune system development. Originally, the infants were randomly assigned to one of three regimens: start ART immediately and continue for 40 weeks; start ART immediately and continue for 96 weeks; or defer ART until signs of clinical or immunological progression to AIDS appeared. The ART regimen consists of ritonavir-boosted lopinavir, zidovudine and lamivudine, provided by GlaxoSmithKline PLC of Britain and the South African Department of Health. CHER is being conducted at two locations in South Africa: the Perinatal HIV Research Unit of the University of Witwatersrand; and the Children's Infectious Diseases Clinical Research Unit of Tygerberg Children's Hospital and Stellenbosch University. These sites are collaborating with the Medical Research Council Clinical Trials Unit in London.

In June 2007, a data and safety monitoring board (DSMB) overseeing CHER found that the babies who received immediate ART were four times less likely to die than the babies whose treatment was deferred. This was true even though 66 percent of those in the deferred treatment arm had met the criteria for ART during the first 32 weeks of the trial and already had begun treatment. Consequently, the DSMB recommended, and NIAID agreed, to assess all the children in the deferred-treatment arm for potential initiation of ART.

The study measured the effectiveness of the treatment strategies by counting the number of babies who died or whose immune systems were not protected by the original ART regimen. After a median of 48 weeks, 10 of 252 infants (4 percent) in the immediate-treatment arms had died, as had 20 of 125 (16 percent) infants in the deferred-treatment arm. Thus, immediate ART reduced deaths by 75 percent. As a secondary measure of success or failure, CHER counted the number of infants who developed HIV-related disease. Such disease developed in 16 babies (6.3 percent) in the immediate-treatment arms and 32 babies (26 percent) in the deferred-treatment arm. Thus, the infants who received treatment immediately were more than four times less likely to develop HIV-related disease.


Story Source:

The above story is based on materials provided by NIH/National Institute of Allergy and Infectious Diseases. Note: Materials may be edited for content and length.


Journal Reference:

  1. A Violari et al. Early antiretroviral therapy reduces mortality in HIV-infected infants: evidence from the CHER trial. New England Journal of Medicine, DOI: 10.1056/NEJMoa0800971

Cite This Page:

NIH/National Institute of Allergy and Infectious Diseases. "Benefits Of Early HIV Testing And Treatment For Infected Infants Defined." ScienceDaily. ScienceDaily, 4 December 2008. <www.sciencedaily.com/releases/2008/11/081120072906.htm>.
NIH/National Institute of Allergy and Infectious Diseases. (2008, December 4). Benefits Of Early HIV Testing And Treatment For Infected Infants Defined. ScienceDaily. Retrieved December 20, 2014 from www.sciencedaily.com/releases/2008/11/081120072906.htm
NIH/National Institute of Allergy and Infectious Diseases. "Benefits Of Early HIV Testing And Treatment For Infected Infants Defined." ScienceDaily. www.sciencedaily.com/releases/2008/11/081120072906.htm (accessed December 20, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Saturday, December 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

The Best Tips to Curb Holiday Carbs

The Best Tips to Curb Holiday Carbs

Buzz60 (Dec. 19, 2014) It's hard to resist those delicious but fattening carbs we all crave during the winter months, but there are some ways to stay satisfied without consuming the extra calories. Vanessa Freeman (@VanessaFreeTV) has the details. Video provided by Buzz60
Powered by NewsLook.com
Sierra Leone Bikers Spread the Message to Fight Ebola

Sierra Leone Bikers Spread the Message to Fight Ebola

AFP (Dec. 19, 2014) More than 100 motorcyclists hit the road to spread awareness messages about Ebola. Nearly 7,000 people have now died from the virus, almost all of them in west Africa, according to the World Health Organization. Video provided by AFP
Powered by NewsLook.com
Researchers Test Colombian Village With High Alzheimer's Rates

Researchers Test Colombian Village With High Alzheimer's Rates

AFP (Dec. 19, 2014) In Yarumal, a village in N. Colombia, Alzheimer's has ravaged a disproportionately large number of families. A genetic "curse" that may pave the way for research on how to treat the disease that claims a new victim every four seconds. Duration: 02:42 Video provided by AFP
Powered by NewsLook.com
The Best Protein-Filled Foods to Energize You for the New Year

The Best Protein-Filled Foods to Energize You for the New Year

Buzz60 (Dec. 19, 2014) The new year is coming and nothing will energize you more for 2015 than protein-filled foods. Fitness and nutrition expert John Basedow (@JohnBasedow) gives his favorite high protein foods that will help you build muscle, lose fat and have endless energy. Video provided by Buzz60
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins