CROI 2019—Early neonatal ART leads to faster HIV suppression


  • Jim Kling
  • Conference Reports
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Takeaway

  • In neonatal HIV-infected patients, initiation of antiretroviral therapy (ART) in the first 7 days of life resulted in a shorter time to viral suppression vs initiation between 7 and 28 days.

Why this matters

  • Faster viral suppression is expected to improve clinical outcomes.

Study design

  • Retrospective analysis of 25 infants in the UK, Spain, Italy, and Thailand treated in the first week of life, and 19 treated after the first week; 57% were female, and 35% preterm.
  • Funding: None disclosed.

Key results

  • Median follow-up, 11.5 (interquartile range, 8.2-15.6) years.
  • Patients with early ART initiation had a higher mean log10 viral load at ART initiation (P=.02). There was no significant difference in CD4 count.
  • Probability of early viral suppression decreased for each week of treatment delay (HR, 0.65; 95% CI, 0.46-0.92), and the effect was strongest in the first year of follow-up.
  • No significant between-group difference in time to virologic failure (2 or more viral load ≥400 copies/mL followed by suppression) or time to blip (1 single viral ≥50-400 copies/mL followed by suppression).

Limitations

  • Small study population.
  • Retrospective.