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Data support HIV treatment recommendations in children
Sturt AS. Pediatr Infect Dis J. 2011;doi:10.1097/INF.0b013e31823515a2.
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Starting highly active antiretroviral therapy for children aged older than 1 year who present with a “category B diagnoses” of HIV is the right approach, and clinicians do not necessarily need to factor in CD4 measurements or plasma HIV RNA level before initiating therapy, according to results of a study published online.
Amy S. Sturt, MD, of Stanford University’s infectious diseases department, and colleagues examined data on 196 children who perinatally contracted HIV between 1988 and 2009. The researchers said 58% of the children received HAART and were followed for 6.2 years.
“Starting HAART before the developmentof moderate or severe disease delayed the median age of diagnosis of moderate disease from 0.4 years without HAART to 3 years with HAART,” they said. “HAART initiation after progression to moderate or severe disease was associated with decreased progression to severe disease or death, respectively.”
However, the researchers said their data also suggest that watchful waiting may be an acceptable approach in those children who are older than 12 months if “they have access to close medical follow-up and present to care with evidence of clinical category B diagnoses or laboratory-based immunosuppression.”
However, they said further data are needed to support those conclusions.
Disclosures: One of the study researchers reports receiving a travel grant from Pfizer to attend the 2010 Infectious Diseases Society of America annual meeting for work unrelated to this publication. Another researcher reports serving on the vaccine advisory boards for Merck and Novartis. The researchers report no other relevant financial disclosures.
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