Featured Research

from universities, journals, and other organizations

Older children with HIV may need to start treatment sooner than thought

Date:
October 29, 2013
Source:
Public Library of Science
Summary:
Although younger children with HIV are at high risk of disease progression if not treated, new research indicates that they have good potential for achieving high CD4 counts (a measure of a type of white blood cell that correlates with immune function) in later life provided antiretroviral therapy is initiated according to current treatment guidelines.

Although younger children with HIV are at high risk of disease progression if not treated, new research published this week in PLOS Medicine indicates that they have good potential for achieving high CD4 counts (a measure of a type of white blood cell that correlates with immune function) in later life provided antiretroviral therapy (ART) is initiated according to current treatment guidelines. However, the research also suggests that the recommended CD4 count thresholds for ART initiation are unlikely to maximize immunological health in children who have never received ART before the age of ten years.

Related Articles


For children aged 2 years, ART initiation is currently recommended once their CD4 count drops below 750 cells/microliter of blood, whereas for older children the threshold for ART initiation is 350 CD4 cells/microliter. Because of improved ART coverage, many more HIV-infected children now survive into adulthood than in the past. It is therefore important to know how the timing of ART initiation in childhood affects long-term immune reconstitution.

The research led by Joanna Lewis from University College London, UK, was an international collaboration and used data collected during the ARROW trial, a study designed to investigate monitoring strategies during first-line HIV treatment in 1,206 HIV-positive children in Uganda and Zimbabwe. In this study the researchers used children's CD4 counts that were collected every 12 weeks for approximately 4 years to analyze how the long-term CD4 count outcomes changed after ART initiation.

In three-quarters of the children, CD4 counts increased rapidly immediately after ART initiation, then slowed before eventually reaching a constant level of about 80% of the CD4 count expected in an HIV-uninfected child of the same age. Using this data the researchers were able to predict CD4 trajectories for children starting ART at different ages and with different CD4 counts. Higher long-term counts were predicted for children starting ART earlier and with higher CD4 counts. However, using current recommended CD4 thresholds for starting ART in children older than 5 years, lower CD4 counts were predicted when they become adults, such that children who have been infected from childbirth and who remain untreated beyond 10 years of age are unlikely ever to normalize CD4 count, regardless of CD4 count at ART initiation.

The authors conclude, "[o]ur results indicate that although younger ART-naive children are at high risk of disease progression, provided they start ART following current WHO/Paediatric European Network for Treatment of AIDS/US Centers for Disease Control and Prevention guidelines, they have good potential for achieving high CD4 levels in later life. However, to attain maximum immune reconstitution in older children, particularly those >10 y, ART may need to be initiated regardless of CD4 cell count."


Story Source:

The above story is based on materials provided by Public Library of Science. Note: Materials may be edited for content and length.


Journal Reference:

  1. Marie-Quitterie Picat, Joanna Lewis, Victor Musiime, Andrew Prendergast, Kusum Nathoo, Addy Kekitiinwa, Patricia Nahirya Ntege, Diana M. Gibb, Rodolphe Thiebaut, A. Sarah Walker, Nigel Klein, Robin Callard. Predicting Patterns of Long-Term CD4 Reconstitution in HIV-Infected Children Starting Antiretroviral Therapy in Sub-Saharan Africa: A Cohort-Based Modelling Study. PLoS Medicine, 2013; 10 (10): e1001542 DOI: 10.1371/journal.pmed.1001542

Cite This Page:

Public Library of Science. "Older children with HIV may need to start treatment sooner than thought." ScienceDaily. ScienceDaily, 29 October 2013. <www.sciencedaily.com/releases/2013/10/131029171834.htm>.
Public Library of Science. (2013, October 29). Older children with HIV may need to start treatment sooner than thought. ScienceDaily. Retrieved December 21, 2014 from www.sciencedaily.com/releases/2013/10/131029171834.htm
Public Library of Science. "Older children with HIV may need to start treatment sooner than thought." ScienceDaily. www.sciencedaily.com/releases/2013/10/131029171834.htm (accessed December 21, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Sunday, December 21, 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