More support for diagnosis and treatment of HIV infection in early infancy

Abstract

In a trial comparing two treatment regimens of antiretroviral therapy (ART) with 48 months of follow-up in young children infected with HIV in South Africa, Shiau et al evaluated specific growth outcomes stratified by the age at initiation of ART. Data show that the trajectory of weight and height growth is more acute in those whose therapy was initiated before 6 months of age. In infants with early initiation of therapy, weight recovery neared population norms within 12 months, and height growth improved over 12-24 months and remained an average 1.0 score below population norms at 48 months of therapy. By 48 months of ART, growth outcomes were similar for groups of treated children regardless of age at commencement. Even though these findings are confirmatory of other studies, the evaluation using age stratification and follow-up over 48 months of therapy is unique among studies in these populations. Rapid weight gain in infancy is likely to be important in ameliorating morbidity and mortality due to non-HIV infectious diseases or other conditions, especially in developing countries. Although it remains to be seen, it is not unreasonable to postulate that more rapid optimization of height could affect long-term height and, possibly, quality of life. These data underscore the importance of initiating ART during early infancy and the critical need to support early infant programs for diagnosis. Article page 1138▶ Initiation of Antiretroviral Therapy Before 6 Months of Age is Associated with Faster Growth Recovery in South African Children Perinatally Infected with Human Immunodeficiency VirusThe Journal of PediatricsVol. 162Issue 6PreviewTo describe the effects of age at antiretroviral therapy (ART) initiation on growth outcomes among children infected with HIV followed for 48 months after treatment initiation. Full-Text PDF