HealthDay News — Starting antiretroviral therapy (ART) for HIV-infected infants within hours of birth does not seem to result in a higher proportion of infants who attain and sustain viral suppression on ART, according to a study published online Jan. 7 in EClinicalMedicine.

Louise Kuhn, PhD, from the Columbia University Irving Medical Center in New York City, and colleagues examined whether HIV-infected neonates who initiated ART <14 days after birth and were maintained on ART would be able to maintain viral suppression when ART was withdrawn. Seventy-three HIV-infected neonates were initiated on ART <14 days after birth and were maintained on ART.

Overall, 3 HIV-infected infants died and 9 were lost to follow-up before age 48 weeks. The researchers found that 52.5% of those surviving the study attained and sustained viral load <50 copies/mL and half of these sustained CD4+ T cell percentage >30%, which were the eligibility criteria for an analytic treatment interruption trial. For the 46 infants starting ART <48 hours after birth and 27 infants starting at 2 to 14 days after birth, the differences in the proportions with achieved and sustained viral load <50 copies/mL (51.4 and 53.9%, respectively) and sustained CD4+ T cell percentage >30% (45.7 and 38.5%, respectively) were not significantly different.

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“The results of our trial suggest that very early treatment in newborns may not have to mean within hours of birth,” Kuhn said in a statement. “Starting ART within the first 2 weeks of life led to similar outcomes to starting within the first 2 days of life.”


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