Journal Article

Early versus Deferred Antiretroviral Multidrug Therapy in Infants Infected with HIV Type 1

Albert Faye, Jerôme Le Chenadec, Catherine Dollfus, Isabelle Thuret, Danièle Douard, Ghislaine Firtion, Eric Lachassinne, Martine Levine, Joelle Nicolas, Fabrice Monpoux, Joelle Tricoire, Christine Rouzioux, Marc Tardieu, Marie Jeanne Mayaux and Stéphane Blanche

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 39, issue 11, pages 1692-1698
Published in print December 2004 | ISSN: 1058-4838
Published online December 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/425739
Early versus Deferred Antiretroviral Multidrug Therapy in Infants Infected with HIV Type 1

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Background. The clinical impact of early antiretroviral multidrug therapy on the risk of early-onset severe human immunodeficiency virus (HIV) disease has not been evaluated on a large scale.

Methods. We evaluated the risk of early-onset events associated with acquired immunodeficiency syndrome (AIDS), particularly the risk of encephalopathy, among infants in the French Perinatal Cohort, according to whether antiretroviral multidrug therapy was initiated before or after the age of 6 months.

Results. Of 83 HIV-infected infants born in 1996 (when HAART became available) or later, 40 received early treatment on or before the age of 6 months, and 43 received deferred multidrug therapy after the age of 6 months. In the group that received early multidrug therapy, no child developed an opportunistic infection or an encephalopathy during the first 24 months of life. In the deferred multidrug therapy group, 6 infants presented with a total of 7 AIDS-associated events (P = .01), 3 of which were encephalopathies (P = .08). The small number of events prevented the identification of clinical and biological markers that accurately predict progression of early-onset severe HIV disease.

Conclusion. In this observational study, infants who received multidrug therapy before 6 months of age did not have the early-onset severe form of childhood HIV disease. Further studies are needed to find accurate early markers of disease progression in this age group.

Journal Article.  4371 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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