The onset of antiretroviral therapy in infants, ideally hours after birth, can restrict the irreparable damage of the developing neonatal immunity system and decrease the persistence of the human immunodeficiency virus (HIV), according to Spanish researcher Pilar García Broncano, of the Institute Ragon of Harvard University and Massachusetts Institute of Technology (MIT), both in the United States. “In recent years, mother-to-child transmission prevention programs have done a great job in controlling maternal / fetal transmission of HIV infection, and thanks to them new infections in newborns have experienced a marked reduction “, explains the researcher also clarifies that this advance is of vital importance because in babies, HIV infection progresses more rapidly than in adults if they do not receive treatment.
Neonatal infection with the HIV-1 virus is associated with a progressive and often fatal deficiency of the immunity system if the treatment is not administered, but the virological and immunological effects of the initiation of antiretroviral therapy within a few hours of birth are not they had investigated. “In many antiretroviral therapy programs, advanced HIV disease in children is recognized even when treatment begins later than the first year of life.” “Therefore, based on other studies with initiation of antiretroviral therapy in the first days of life, we decided to assess whether an early ‘test and treat’ strategy, at least in the context of a clinical trial, was possible in sub-Saharan Africa, where it is estimated that between 300-500 newborns and babies are infected every day with HIV-1, “explains García Broncano.
These advances have been more significant in Africa, as it hosts the largest number of cases worldwide of pregnant women with HIV infection. “However, the coverage of antiretroviral drugs among pregnant women with HIV varies significantly from one region to another, being more marked in low-income and middle-income countries, so neonatal HIV infection continues to be a huge challenge. of global health, “he added.
Between April 2015 and July 2018, researchers examined data from 10,600 newborns in Botswana to diagnose HIV infection and selected cases to start ART in the first days of life. The first 10 babies who completed the two years of treatment were incorporated into the study, to determine if an early diagnosis of HIV infection at birth could improve the response to treatment, reduce the viral reservoir and improve immune function, concluding that yes .
“Without treatment, 50% of infected children die at two years of age, and it has been shown that the beginning of treatment in the first weeks or months of life improves survival,” said Roger Shapiro, one of the participants in the study.