Early Treatment for HIV Babies Saves Lives

Earlier this year, Health News published an article concerning HIV testing during pregnancy to reduce the incidence of babies born HIV positive. The testing was encouraged to allow for the proper antiviral treatment of mothers during pregnancy to reduce babies being born with HIV. Almost exclusively mothers who are HIV positive give birth to children with the infection or pass it to their infants while breastfeeding. There were an estimated 500,000 HIV infected infants born in 2006.

Untreated HIV produces infants with AIDS and a decade ago doctors were in despair in the treatment of these patients. Infants do not have the same immune systems as adults or even children and with AIDS weakened immune systems they are more susceptible to other illnesses and even death if they are not diagnosed and treated. A 2007 study has indicated that early diagnoses of infants with HIV are crucial if they are to be effectively treated. Early treatment produces more effective results and the progression of the disease is greatly limited.

The lead researcher in the study was Dr. Avy Violari, from the Comprehensive International Program of Research on AIDS. The study involved 377 HIV positive South African babies. Antiretroviral drugs were given to 252 of the infants immediately while the others were given medications only when symptoms occurred. In those given early medication mortality was reduced by 76 percent and HIV progression by 75 percent. Babies given treatment early had less developmental problems than the other babies because the treatment also helped protect their brains from the effects of HIV.

Edward Handelsman, a pediatrician at the National Institute of Allergy and Infectious Disease in Bethesda, MD, “I think it’s a landmark trial. It’s the first large, randomized clinical trial which absolutely, positively establishes this benefit to early treatment. And it provides a path—as far as I’m concerned a mandate—to start improving our methods of identifying [HIV positive] infants early.”
According to Dr. Violari “When these early data were analyzed, it became clear that treating all infants at the earliest opportunity after diagnosis was the best course of action.” As a result of the study the World Health Organization changed its guidelines which had recommended delaying treatment until symptoms appeared.

The findings were released in July 2007 and in the Nov. 20 issue of the New England Journal of Medicine another study, confirming those findings was published. The South African study was discontinued in 2007 because the results were so apparent that early treatment was the most effective for the patients. Babies who had been deferred from treatment until symptoms appeared were put on early treatment as a result of the study.

Developing countries have and will continue to have a high rate of HIV infected babies until their counties can sustain peace and guarantee good medical practices. Babies born of HIV infected mothers in this country should not face the same challenges. With proper pre-birth testing during pregnancy and immediate therapy there could be a time when no infant in this country has to suffer the devastation of the disease.

The study was funded by the National Institute of Allergy and Infectious Diseases, the Department of Health of the Western Cape and Gauteng, South Africa, and by GlaxoSmithKline.