When should children with HIV infection be started on anti-HIV medications?

March 25, 2008

The advent of effective medications for treating HIV dramatically improved the outlook for both adults and children infected with HIV who had access to treatment, but the optimal timing for starting treatment remains controversial, particularly in children. A debate article in this week's PLoS Medicine lays out the case for deferred treatment against the case for early initiation of treatment in children infected with HIV.

In laying out the case for deferred treatment, Dr Steven Welch (Consultant in Paediatric HIV and Infectious Diseases, Heartlands Hospital, Birmingham, UK) says that, "it remains rational to consider an individual child’s and family’s wishes and circumstances as well as the child’s risk of disease progression in deciding when to start treatment."

The hasty and injudicious use of antiretroviral medications in children, he argues, risks creating a cohort that has learned poor adherence habits, is infected with multi-drug-resistant viruses, and has been exposed to unnecessary cumulative drug toxicities.

Arguing the case for early initiation, Professor Di Gibb (Professor in Epidemiology and a Consultant Paediatrician at the Medical Research Council Clinical Trials Unit, London, UK), says that "deferring treatment initiation for as long as possible is no longer an option." Professor Gibb lays out several reasons why she believes that early initiation is even more important in children than in adults—for example, children with HIV grow better if they receive antiretroviral medication.

Both authors point out that there has never been a clinical trial conducted on determining when to start antiretroviral medications in children, and they conclude by saying that the time has come to conduct such a trial.

Citation: Welch SB, Gibb D (2008) When should children with HIV infection be started on antiretroviral therapy" PLoS Med 5(3): e73.

Source: Public Library of Science

Explore further: Common treatments for children with HIV equally effective, study shows

Related Stories

Treating HIV-infected infants early helps them live longer

July 25, 2007

Hundreds of thousands of babies around the world are born each year with HIV--more than half a million in 2006 alone. Caring for these children is complicated by the fact that their immune systems are not fully developed ...

HIV testing for children must be improved

July 20, 2010

National HIV programs should recognize that HIV testing and counseling systems designed for adults do not meet the needs of children. Therefore, according to Scott Kellerman from Management Sciences for Health, Virginia, ...

Recommended for you

How the finch changes its tune

August 3, 2015

Like top musicians, songbirds train from a young age to weed out errors and trim variability from their songs, ultimately becoming consistent and reliable performers. But as with human musicians, even the best are not machines. ...

Machine Translates Thoughts into Speech in Real Time

December 21, 2009

(PhysOrg.com) -- By implanting an electrode into the brain of a person with locked-in syndrome, scientists have demonstrated how to wirelessly transmit neural signals to a speech synthesizer. The "thought-to-speech" process ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

not rated yet Mar 26, 2008
I would share it with the StD datig site ww.STDRomance.com

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.