Navigation Links
Asymptomatic HIV babies could use earlier treatment

Identifying and treating HIV-infected newborns is a race against the clock, according to a study from the Stanford University School of Medicine and Lucile Packard Children’s Hospital. Researchers found that HIV-infected infants treated with one or two antiretroviral drugs within two months of birth were less likely to develop AIDS by their third birthday than were infants who were 3 or 4 months old when treatment was initiated. Infants who received a combination of three antiretroviral drugs did even better.

“This is an important finding because there’s been a lot of controversy in the literature as to whether infected but asymptomatic infants should be started on therapy right away,?said the study’s senior author Yvonne Maldonado, MD, a pediatric infectious disease expert at Lucile Packard Children’s Hospital and an associate professor of pediatrics at Stanford’s School of Medicine.

Without any kind of treatment, about 20 to 30 percent of HIV-infected infants will develop AIDS by around 4 months of age. The rest will not have advanced symptoms until they are about 6 years old. The study, published May 11 in the Journal of the American Medical Association, suggests that early treatment might be appropriate for at least some apparently healthy infected infants.

“There is a significant difference in the likelihood of disease progression [with earlier treatment], even though there is only about a month separating the initiation of therapy in the two groups,?Maldonado said. “And none of the children who received triple therapy progressed to AIDS before their third birthday, regardless of the age at which they began therapy.?(Therapy with a combination of three drugs, known as highly active antiretroviral therapy, or HAART, was not available when the study began in 1988.)

Current guidelines for treating HIV-infected infants leave the decision of when to begin treatment to the child’s physician—in part because the long-term effects of ongoi ng antiretroviral treatment are not known. Concerns about the drugs?possible toxic side-effects and the development of viral resistance to available treatments must be balanced against a desire to do everything possible to keep infected children healthy.

Maldonado and her colleagues collected data from hospitals throughout northern California over a 17- year period. Statistical calculations indicate that their sample of 205 children represent nearly every HIV-infected child born in the area during that time—an unbiased sample that allowed them to analyze all infected babies, not just the sickest. “We were able to analyze children with the full spectrum of disease across many years, rather than using mathematical models to predict the development of illness in the children,?said Maldonado. “We were able to see the real distribution of illness, what kinds of treatment the children were given and the ages when they started treatment.?/p>

The researchers divided the HIV-infected newborns into three groups: those born from 1988 to 1991, from 1992 to 1995 and from 1996 to 2001 based on the types of therapy available in those years. Members of the early group were usually evaluated for infection by their first birthday; those in the middle and late groups were assessed within the first month. Those in the late group benefited from the introduction of a special type of antiretroviral drug called a protease inhibitor. They followed the children for the first three years of life, tracking at what age they developed AIDS and the rate of survival through their third birthday.

As might be expected, infants born later in the study period were more likely to receive triple therapy and less likely to experience AIDS-related complications or death. In fact, none of the 23 children who received triple therapy died or developed AIDS before their third birthday. In contrast, about 55 percent of the children in the first two groups died of AIDS. When the researchers compared the outcomes in the first two groups, they found that any type of antiretroviral therapy delayed disease progression and enhanced survival.

“We’ve clearly shown that early treatment of asymptomatic infants—no matter what it is—makes a big difference in preventing or delaying the progression of the disease,?said Maldonado. “Now we have to move forward to figure out if this treatment is going to be appropriate for everyone.?/p>

Clinical trials are needed to determine if every infected newborn should be treated or if some subsets of infants will benefit more than others, Maldonado explained. In the meantime, the findings emphasize the importance of testing pregnant women for HIV and watching for signs of infection in the newborns of women who have tested positive for HIV.

The study was supported by funding from the Office of AIDS at the California Department of Health Services. Researchers from 10 institutions participated in the study, including Maldonado and three others from Stanford’s Department of Pediatrics.


'"/>

Source:Stanford University


Related biology news :

1. OHSU research shows vitamin C counteracts some negative impacts of smoking on unborn babies
2. New brain scan technology could save babies lives
3. New tool tracks brain development in babies
4. Todays babies are fatter babies
5. Research offers new hope for preterm babies
6. Hair samples show babies can be exposed to crystal meth while in the womb
7. Solvent exposure linked to birth defects in babies of male painters
8. Designer babies - what would you do for a healthy baby?
9. Why do cold animals make bigger babies?
10. A revolution in the monitoring of unborn babies
11. Thymus transplants gives hope to babies with fatal immune disease
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:5/12/2016)... , May 12, 2016 WearablesResearch.com ... just published the overview results from the Q1 wave ... the recent wave was consumers, receptivity to a program ... data with a health insurance company. "We ... to share," says Michael LaColla , CEO of ...
(Date:5/3/2016)... 3, 2016  Neurotechnology, a provider of high-precision ... Automated Biometric Identification System (ABIS) , a complete ... MegaMatcher ABIS can process multiple complex biometric transactions ... of fingerprint, face or iris biometrics. It leverages ... and MegaMatcher Accelerator , which have been ...
(Date:4/28/2016)... -- First quarter 2016:   , Revenues ... first quarter of 2015 The gross margin was 49% ... and the operating margin was 40% (-13) Earnings per ... from operations was SEK 249.9 M (21.2) , Outlook ... 7,000-8,500 M. The operating margin for 2016 is estimated ...
Breaking Biology News(10 mins):
(Date:6/27/2016)... 27, 2016 /PRNewswire/ - BIOREM Inc. (TSX-V: BRM) ("Biorem" or ... its major shareholders, Clean Technology Fund I, LP and ... based venture capital funds which together hold ... a fully diluted, as converted basis), that they have ... entire equity holdings in Biorem to TUS Holdings Co. ...
(Date:6/27/2016)... ... 2016 , ... Parallel 6 , the leading software as a service ... Virtual Patient Encounter CONSULT module which enables both audio and video telemedicine communication ... , Using the CONSULT module, patients and physicians can schedule a face to face ...
(Date:6/27/2016)...  Liquid Biotech USA , ... Sponsored Research Agreement with The University of Pennsylvania ... cancer patients.  The funding will be used to ... clinical outcomes in cancer patients undergoing a variety ... employed to support the design of a therapeutic, ...
(Date:6/24/2016)... 24, 2016 Epic Sciences unveiled a ... susceptible to PARP inhibitors by targeting homologous recombination ... The new test has already been incorporated into ... cancer types. Over 230 clinical trials ... pathways, including PARP, ATM, ATR, DNA-PK and WEE-1. ...
Breaking Biology Technology: