Antiretroviral therapy is safe and effective from infancy
New data provide further evidence of the safety and efficacy of antiretroviral therapy when started in infancy.
Researchers say that HIV disease can progress rapidly in children but
that few data address the efficacy of aggressive therapy. They looked
at three antiretroviral regimens in HIV-infected children started at
three months or younger for up to 200 weeks. The trial was a multicentre,
open-label study involving 52 children.
Results showed that a combination of stavudine, lamivudine, nevirapine
and nelfinavir appeared more efficacious than two regimens of reverse-transcriptase
inhibitors in terms of viral suppression at 48 and 200 weeks. Early initiation
of therapy (at three months or earlier) also appeared to be associated
with improved long-term suppression of viral replication.
The authors note that European guidelines recommend the initiation of
therapy in young infants only if they have clinical AIDS, less than 20
per cent CD4 T cells or viral load persistently over 106 copies/ml. They
call for further study of their findings in larger, randomised trials
(New England Journal of Medicine 2004;350:2471). |
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