Navigation Links
Landmark study defines benefits of early HIV testing and treatment for infected infants

Testing very young babies for HIV and giving antiretroviral therapy (ART) immediately to those found infected with the virus dramatically prevents illness and death, according to a report in the New England Journal of Medicine. The study found that giving ART to HIV-infected infants beginning at an average age of 7 weeks made them four times less likely to die in the next 48 weeks, compared with postponing ART until signs of illness or a weakened immune system appeared--the standard of care when the study began.

These findings come from the "Children with HIV Early Antiretroviral Therapy" (CHER) study, the first Phase III randomized clinical trial to study the best time to begin ART in infants. Launched in South Africa in July 2005, CHER is sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and the departments of health of the Western Cape and Gauteng in South Africa.

"HIV devastates the nascent immune systems of infants very quickly, yet too many HIV-infected infants do not get tested for the virus, get tested too late or get tested but lack access to lifesaving antiretroviral drugs," says Anthony S. Fauci, M.D., the director of NIAID. "The results of CHER are a clarion call to scale up widespread early HIV testing of at-risk infants and to make ART immediately accessible to all infants who test positive."

Preliminary results of CHER, released in July 2007, showed that HIV-infected infants were four times less likely to die if given ART immediately after HIV diagnosis ( This finding helped influence the World Health Organization (WHO) to change its guidelines for treating HIV-infected infants. The new guidelines, issued in April 2008, strongly recommend starting ART in children under age 1 immediately after HIV diagnosis, regardless of their state of health. An NIAID study to identify the best drug regimen for these highly vulnerable children is under way.

"The new WHO guidelines will profoundly improve the survival rate and quality of life of infants born with HIV," says Ed Handelsman, M.D., chief of the Pediatric Medicine Branch in NIAID's Division of AIDS. "We are excited that we know the best time to begin treating HIV-infected infants; the challenge now for the global community is to ensure that all HIV-infected infants who need ART receive it soon enough."

The CHER study team, lead by Avy Violari, FCPaed, and Mark F. Cotton, MMed PhD, recruited and enrolled 377 infants between 6 and 12 weeks of age who had confirmed HIV infection but normal immune system development. Originally, the infants were randomly assigned to one of three regimens: start ART immediately and continue for 40 weeks; start ART immediately and continue for 96 weeks; or defer ART until signs of clinical or immunological progression to AIDS appeared. The ART regimen consists of ritonavir-boosted lopinavir, zidovudine and lamivudine, provided by GlaxoSmithKline PLC of Britain and the South African Department of Health. CHER is being conducted at two locations in South Africa: the Perinatal HIV Research Unit of the University of Witwatersrand; and the Children's Infectious Diseases Clinical Research Unit of Tygerberg Children's Hospital and Stellenbosch University. These sites are collaborating with the Medical Research Council Clinical Trials Unit in London.

In June 2007, a data and safety monitoring board (DSMB) overseeing CHER found that the babies who received immediate ART were four times less likely to die than the babies whose treatment was deferred. This was true even though 66 percent of those in the deferred treatment arm had met the criteria for ART during the first 32 weeks of the trial and already had begun treatment. Consequently, the DSMB recommended, and NIAID agreed, to assess all the children in the deferred-treatment arm for potential initiation of ART.

The study measured the effectiveness of the treatment strategies by counting the number of babies who died or whose immune systems were not protected by the original ART regimen. After a median of 48 weeks, 10 of 252 infants (4 percent) in the immediate-treatment arms had died, as had 20 of 125 (16 percent) infants in the deferred-treatment arm. Thus, immediate ART reduced deaths by 75 percent. As a secondary measure of success or failure, CHER counted the number of infants who developed HIV-related disease. Such disease developed in 16 babies (6.3 percent) in the immediate-treatment arms and 32 babies (26 percent) in the deferred-treatment arm. Thus, the infants who received treatment immediately were more than four times less likely to develop HIV-related disease.


Contact: Laura Sivitz
NIH/National Institute of Allergy and Infectious Diseases

Related medicine news :

1. Document Security Systems (Amex: DMC) Invites You to a Landmark Event
2. Less than one-third of women aware of landmark hormone therapy study, Stanford researcher finds
3. Pathway to cell death redefined in landmark study
4. Pathway to cell death redefined in landmark study
5. UCLA to lead local study center in landmark government study of child health
6. Landmark Report: Excess Body Fat Causes Cancer
7. In Landmark Phase III Head-to-Head Study, Prasugrel Statistically Superior to Clopidogrel in Reducing Risk of Heart Attack
8. Landmark trial to evaluate cardioprotective properties of insulin
9. Safeway Inc. and the Prostate Cancer Foundation to Fund Landmark Prostate Cancer Research Collaboration
10. Yale launches landmark VIRGO study of young women with heart disease
11. Hospital Launches Landmark Project in Emergency Medicine
Post Your Comments:
(Date:11/27/2015)... ... November 27, 2015 , ... ... Microsoft Dynamics SL User Group (MSDSLUG). Recognized as Microsoft’s official group for end ... Microsoft Dynamics SL software users, partners, industry experts and representatives. Intellitec Solutions’ membership ...
(Date:11/27/2015)... ... November 27, 2015 , ... The moment ... itself for not only fulfilling the needs of advisers and clients but going ... price and providing top-tier customer service. However, there's always room for improvement, which ...
(Date:11/27/2015)... ... , ... CBD College is proud to announce that on November ... to its Diagnostic Medical Sonography program. CBD College is honored to join this very ... and universities in the state of California make the cut. CBD College is officially ...
(Date:11/27/2015)... ... November 27, 2015 , ... Dr. Thomas Dunlap and Dr. ... Tucker Bierbaum with Emergency Medicine at St., Joseph Health System’s Santa Rosa Memorial ... conditions present in similar ways and require time-critical intervention to avoid large area heart ...
(Date:11/27/2015)... ... November 27, 2015 , ... Indosoft ... announces the incorporation of Asterisk 11 LTS (Long Term Support) into its Q-Suite ... LTS brings Q-Suite 5.10 up-to-date with a version of Asterisk that will receive ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... Nov. 25, 2015  The American Academy of ... (ACOG), and the March of Dimes cheered today,s ... Our Infants Act of 2015 (S.799), which ... newborns born exposed to drugs, such as opioids, ... introduction, all three organizations have worked together leading ...
(Date:11/25/2015)... On Tuesday, November 24, 2015, the ... Wright Medical Technology, Inc. for product liability and ... implant device, awarded $11 million in favor of ... and three days of deliberations, the jury found ... designed and unreasonably dangerous, and that Wright Medical ...
(Date:11/25/2015)... , November 25, 2015 ... KTOV ) (TASE: KTOV), a biopharmaceutical company focused on ... of various clinical conditions, today announced the closing of ... Depository Shares ( ADSs ), each representing 20 ordinary ... to 3,158,900 ADSs. The ADSs and warrants were issued ...
Breaking Medicine Technology: