|Treating HIV-infected babies within the first few hours and days after birth was found to significantly improve their chances of better, long-term health / Photo by: cawee via Shutterstock|
Treating HIV-infected babies within the first few hours and days after birth was found to significantly improve their chances of better, long-term health. Researchers from Harvard and MIT found that giving infants HIV treatment right after birth preserves their immune systems and leads to fewer infected cells in their blood compared to those who had treatment later on.
While treating HIV-infected pregnant women with active drugs to prevent transmission to the babies, there is still a chance that the infant will contract the virus. So the findings of the new study provide new hope for children with HIV to live better lives and lift the viral burden of the disease early on.
Early Treatment Approach
The study looked into the effects of early and later HIV treatments for infected newborns, with results detailed in the journal Science Translational Medicine. Reuters reported that the researchers involved a group of 40 HIV-infected infants in Botswana for the study. About 24% of pregnant women in Botswana are living with AIDS-inducing virus.
Results of the study were based on the treatment of the first 10 infants given antiretroviral therapy (ART) within hours and days after birth and 10 others who started treatment four months later. They compared the outcomes to 54 infants without HIV two years after the treatment.
Infants who were given early treatment were found to have stronger immune systems and fewer damaged immune cells. These babies also have 200 times fewer dormant HIV-infected cells (cells that can reactivate and start replicating to infect other cells).
|Reuters reported that the researchers involved a group of 40 HIV-infected infants in Botswana for the study. About 24% of pregnant women in Botswana are living with AIDS-inducing virus / Photo by: Adam Jan Figel via Shutterstock|
Up to 50% of HIV-infected children are likely to die in the first two years of their life if they don't receive treatment, reported the New Scientist, a London-based magazine that provides the latest news on science and technology.
Roger Shapiro, a part of the research team from Harvard, said testing and treatment should be provided early on and whenever it is feasible. He added that HIV transmissions, which can occur during pregnancy, childbirth, and breastfeeding, can be prevented by giving mothers treatment. "But for the few who slip through this safety net, we owe it to them to provide diagnosis and treatment as quickly as possible," he said.
The New Scientist said the results provide additional evidence that early treatment can improve health outcomes for HIV-infected children. Early works showed that treating children for the virus at 6 to 12 weeks can cut the risk of death by 76% and HIV progression by 75% compared to infants who were treated when they reached a year old.
Breaking Barriers in Treatment
In 2018, UNICEF estimated that 2.8 million children aged 0 to 19 months are living with HIV and about 980 more are infected each day. Out of these, 320 died from AIDS-related causes mainly due to lack of access to HIV prevention, care, and treatment.
Obscured access is only one of the key barriers that prevent infected children from getting the treatment they needed. The first challenge is to accurately diagnose HIV in newborns.
The World Health Organization guidelines state that children should immediately be tested for HIV. However, standard antibody tests can't be used until they are at least 18 months old "because they still have circulating antibodies from their mothers," the researchers said, as per The Conversation, an Australia-based, not-for-profit media outlet that uses content sourced from academics and researchers.
In the Harvard-MIT study, the researchers found they can make a correct diagnosis if they test a second sample for every child who was initially screened positive or indeterminate.
"Since this does not happen often—less than 1% of tests in our setting—this repeat test strategy was feasible, and it provided enough diagnostic certainty to immediately offer treatment to infected newborns without fear of misdiagnosis," they said.
|In 2018, UNICEF estimated that 2.8 million children aged 0 to 19 months are living with HIV and about 980 more are infected each day / Photo by: Michael715 via Shutterstock|
Limited drugs are also a challenge in HIV treatment. Only two drugs were safe to use immediately after birth, and others can only be used when the child is at least two weeks old. Bad-tasting medicine and difficult-to-use drugs are also concerns that can delay treatment.
The scientists found that newborns can "tolerate HIV treatment well" and can quickly suppress the virus if given the right support. An example of this support is to have opportunities for frequent contact with health providers early in life to help a child stay on medications.
"In our study, we frequently partnered with nurses at postnatal care clinics to help with adherence counseling and even direct observation of dosing, and these partnerships helped improve treatment responses," the researchers explained.
Despite these barriers, there is still some good news: The number of new HIV infections among children has declined by 41% since 2010, thanks to additional efforts in preventing mother-to-child transmissions. This highlights the importance of onset treatment for the virus, which provides infected newborns the opportunity for better, long-term health free from HIV.