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Cape Town, South Africa – Early antiretroviral therapy (ART) initiation in children with perinatal HIV (CHIV) shows remarkable promise in preserving lung function into adolescence, according to a recent study. The research, led by Andre Gie from Stellenbosch University and published in the American Journal of Respiratory and Critical Care Medicine, highlights the long-term benefits of early HIV care.
The study followed 102 CHIV and 129 age-matched peers, including HIV-exposed but uninfected children and unexposed children, from September 2013 to March 2020. The CHIV cohort began ART at a median age of 9 weeks. Pulmonary function testing (PFT) during adolescence revealed no significant differences in lung function between CHIV and their HIV-negative peers.
Key Findings
- High Virologic Suppression: At the time of testing, 94.2% of CHIV maintained virologic suppression.
- Comparable Lung Function: Spirometry outcomes and lung volumes were similar between CHIV and children without HIV, indicating that early ART can mitigate lung health impacts associated with perinatal HIV.
- Small Airway Dysfunction: Although small airway dysfunction was more common in CHIV (11.27%) than in children without HIV (2.7%), the overall risk difference was minimal (absolute risk difference: 0.09).
“We demonstrate that early ART combined with high-quality, basic medical care throughout childhood may mitigate the effect of perinatal HIV on children’s lung health,” the authors concluded.
Challenges and Limitations
The researchers noted some challenges, including early mortality in the parent trial, significant loss to follow-up among HIV-negative children, and limited investigation of small airway function. They also acknowledged that the findings might not generalize to all healthcare settings due to varying levels of healthcare access.
Future Implications
The results emphasize the importance of early HIV diagnosis and immediate ART initiation to safeguard the long-term health of children with perinatal HIV. The study underscores the potential for reducing HIV-associated complications with timely interventions and continuous care.
Study Support
The research was funded by multiple organizations, including the Collaborative Initiative for Paediatric HIV Education and Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the South African Medical Research Council.
With ongoing advancements in ART and pediatric HIV care, this study offers hope for a future where CHIV can grow into adulthood with lung health comparable to their peers.
