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Treating HIV-infected infants very early substantially improves health: Study
Without treatment, 50% of HIV-infected children progress to death within two years
A small study of African infants infected with HIV found that treating them with powerful drugs within the first hours and days of birth helped preserve their immune systems, improving their chances of better long-term health, U.S. researchers said on Wednesday.
HIV infections in newborns pose a huge health burden in developing countries. One study estimated that 300 to 500 infants are infected every day in sub-Saharan Africa.
“Without treatment, 50% of HIV-infected children progress to death within two years,” study co-author Dr. Roger Shapiro of the Harvard T.H. Chan School of Public Health said in a telephone briefing with reporters.
The study, published in the journal Science Translational Medicine, builds on discoveries of infants whose HIV was thought to have been cured after receiving antiretroviral therapy (ART) within weeks of birth. The first such case involved a Mississippi infant born in 2010 who was treated within 30 hours of birth and was able to control her virus for several months after treatment was stopped.
In the new study, a team of Harvard and MIT researchers tested this early treatment approach on a group of 40 HIV-infected infants in Botswana, where 24% of pregnant women are living with the virus that causes AIDS.
The researchers reported results of the first 10 infants who were given ART within hours and days of birth, 10 infected infants who began treatment four months after birth and compared those with 54 infants without HIV.
The earliest-treated infants showed a much smaller viral reservoir – the pool of virus that persists through life even during treatment – than the second infant group after 96 weeks, researchers reported.
Babies in the earliest treatment group also had more robust immune systems than even the infants without HIV, researchers found.
Current World Health Organization guidelines recommend infected newborns receive ART within weeks of birth to suppress the virus, which can otherwise quickly lead to rapid and fatal immune deficiency.
Shapiro said the earlier treatment strategy is not a cure, but could be combined with other interventions as part of research toward an HIV cure.
The research team said that some of the children may be enrolled in a trial testing the use of protective antibodies specifically engineered to neutralize HIV to see if the approach could help the infants control the disease without the need for lifelong treatment. That trial is set to start in 2020.
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