Treating Infants Early Increases Survival

Picture: A baby

With HIV-treatment it seems to be
best to start early; ©

Hundreds of thousands of babies around the world are born each year with HIV. The current standard of HIV care in many parts of the world is to treat infants with antiretroviral therapy − but only after they show signs of illness or a weakened immune system.

“Children with HIV infection frequently show rapid disease progression within the first year of life due to their developing immune systems and susceptibility to other serious infections,” says National Institutes of Health (NIH) Director Elias A. Zerhouni, M.D. “The trial, called “Children with HIV Early Antiretroviral Therapy” (CHER) study is the first randomized clinical trial that shows that infants treated before three months of age will do better than infants who have their treatment delayed.”

The evidence came to light after a routine review by the trial’s data and safety monitoring board (DSMB). CHER started in July 2005. HIV-infected infants between six and twelve weeks old without immune suppression or severe symptoms of clinical disease were enrolled.

By early 2007, 377 babies were enrolled in one of three groups − those receiving immediate antiretroviral therapy for 40 weeks, those receiving immediate antiretroviral therapy for 96 weeks, and a control group whose treatment was initiated after doctors observed signs of clinical or immunological progression toward the development of AIDS (the current standard of HIV care in many parts of the world).

The trial is designed to continue through 2011, but after reviewing early trial data on June 20, 2007, the DSMB found a significant increase in survival among infants who received immediate antiretroviral therapy. At the time of the DSMB review, 96 percent of these children were alive, compared to only 84 percent of the children in the control group. Based on this finding, the DSMB concluded that providing early antiretroviral therapy to infants is more effective in preventing early death than delaying treatment until clinical or immunological disease triggers are observed.; Source: NIH/National Institute of Allergy and Infectious Diseases