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Only one-third of eligible children receive ART
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Despite implementation of a global plan to eliminate pediatric HIV, 210,000 new pediatric infections were added worldwide in 2012, and 230,000 children died of an AIDS-related illness in 2011, according to report data published in PLOS Medicine.
“Expanding the focus on pediatric HIV is a collective effort and many experts in the field are aligned on what they know to be the existing barriers and potential solutions to ensuring equity in access to care and treatment for children infected and affected by HIV,” wrote Scott E. Kellerman, MD, of Management Sciences for Health, and Nandita Sugandhi, MD, of Clinton Health Access Initiative.
WHO guidelines for prevention of mother-to-child transmission, established in 2013, call for earlier initiation of ART in all children younger than 5 years and longer periods of prophylaxis for pregnant and breast-feeding women to help ensure protection. Children whose mothers never accessed prophylaxis as part of a prevention of mother-to-child transmission are at the greatest risk for HIV infection, and must be identified, diagnosed and linked to HIV care and treatment.
“Children are more vulnerable to HIV infection and have higher morbidity and mortality,” researchers wrote. “Without treatment, one-half of those children infected will die before the age of 2 years, yet only one-third of those eligible for treatment are currently receiving ART.”
In 2011, 59% of pregnant women with HIV living in sub-Saharan Africa received ART or prophylaxis, but more than 40% of infants remained vulnerable to HIV infection.
“If we can overcome the barriers to early ART initiation of children on ART, we can expect that those children will survive to adolescence, necessitating the creation of adolescent-friendly programs to address new challenges around sexual debut and transmission and transitioning to adult care,” researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
Scott E. Kellerman, MD, can be reached at skellerman@msh.org.
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