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| http://dx.doi.org/10.1016/S2055-6640(20)30240-5 | DOI Listing |
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High mortality following early initiation of antiretroviral therapy in infants living with HIV from three African countries.
EClinicalMedicine
July 2024
Fundación de Investigación Biomédica Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain.
Article Synopsis
- The study examined outcomes for infants with perinatally-acquired HIV who started early ART in South Africa, Mozambique, and Mali, focusing on mortality, viral suppression, and engagement in care over three years.
- Out of 215 infants monitored, the 1-year death probability was 10%, which rose to 12% by the second and third years, with high baseline viral load identified as a significant risk factor for mortality.
- Of the children, only 42% maintained sustained viral control for a year, with adherence to ART deemed optimal in 81% of visits, although lower adherence was linked to female sex at birth, younger diagnosis age, and adverse maternal social circumstances.
Analytical treatment interruption in children living with HIV: position statement from the EPIICAL consortium.
Lancet HIV
October 2024
Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy; Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.
Analytical treatment interruption (ATI) is widely acknowledged as an essential component of studies to advance our understanding of HIV cure, but discussion has largely been focused on adults. To address this gap, we reviewed evidence related to the safety and utility of ATI in paediatric populations. Three randomised ATI trials using CD4 T-cell and clinical criteria to guide restart of antiretroviral therapy (ART) have been conducted.
View Article and Find Full Text PDFOptimizing the World Health Organization algorithm for HIV vertical transmission risk assessment by adding maternal self-reported antiretroviral therapy adherence.
BMC Public Health
July 2022
Pediatrics Department, Pediatric Research and Clinical Trials Unit (UPIC), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (IMAS12), Madrid, Spain.
Background: The World Health Organization (WHO) risk assessment algorithm for vertical transmission of HIV (VT) assumes the availability of maternal viral load (VL) result at delivery and early viral control 4 weeks after initiating antiretroviral treatment (ART). However, in many low-and-middle-income countries, VL is often unavailable and mothers' ART adherence may be suboptimal. We evaluate the inclusion of the mothers' self-reported adherence into the established WHO-algorithm to identify infants eligible for enhanced post-natal prophylaxis when mothers' VL result is not available at delivery.
View Article and Find Full Text PDFReport from the First EPIICAL (Early-treated Perinatally HIV-infected Individuals: Improving Children's Actual Life with Novel Immunotherapeutic Strategies) General Assembly meeting, 9-11 November 2017, Rome, Italy.
J Virus Erad
January 2018
Academic Department of Pediatrics (DPUO), Research Unit in Congenital and Perinatal Infection, Immune and Infectious Diseases Division, Children's Hospital Bambino Gesù (OPBG), Rome, Italy.
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