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Study: For HIV-Infected Babies, Treatment Should Start At Birth

Nov 28, 2019
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Every day, as many as 500 babies in sub-Saharan Africa are born with HIV. Now a study out of Botswana finds that if newborns are given treatment right away, the virus becomes almost undetectable. NPR's Pien Huang reports.

PIEN HUANG, BYLINE: If a baby tests positive for HIV, standard practice in many sub-Saharan countries is to give them treatment, but not for weeks or even months after they're born. The concern is that newborns can't tolerate these powerful drugs. For some time, though, researchers have a hunch that treating right at birth is better. Deborah Persaud is a virologist at Johns Hopkins, and she wrote a paper six years ago about a baby girl in Mississippi with HIV who was treated 30 hours after birth.

DEBORAH PERSAUD: That baby was known to be infected, went off drugs. And then for 27 months, there was no signs of HIV.

HUANG: But researchers weren't sure if this would work in other babies. A new clinical trial in Botswana gives an answer. Ten HIV-positive babies were given a three-drug cocktail within their first days. Writing in the journal Science Translational Medicine, the researchers report that two years out, these babies have very little virus in their bodies. Daniel Kuritzkes, a study co-author and a doctor at Brigham and Women's Hospital in Boston, says the kids aren't cured yet.

DANIEL KURITZKES: But it's likely that we may have set them up for the possibility of long-term remission of their HIV.

HUANG: Kids that started drugs months after birth had 200 times more virus in their blood than those given treatment right away. Persaud at Johns Hopkins, who was not involved in the study, says it shows that giving drugs soon after birth keeps the virus from taking firm hold in the body.

PERSAUD: Giving this very early treatment limited establishment of a long-lived reservoir.

HUANG: While it's great to know that treating earlier is better, Kuritzkes says one of the biggest hurdles will be getting drugs to babies that need them.

KURITZKES: You really need the kind of infrastructure that exists in Botswana or in a country like the United States in order to be able to identify and rapidly intervene in these children.

HUANG: About half the babies in sub-Saharan Africa infected with HIV don't have access to antiretroviral drugs. Researchers say that needs to change. Pien Huang, NPR News. Transcript provided by NPR, Copyright NPR.