A study in the Nov. 20 issue of the New England Journal of Medicine reveals that, for infants with HIV, early therapy reduces mortality, treatment failure and disease progression.

“I think it’s a landmark trial. It’s the first large, randomized clinical trial which absolutely, positively establishes this benefit to early treatment. And it provides a path – as far as I’m concerned a mandate – to start improving our methods of identifying [HIV-positive] infants early,” says Edward Handelsman, a pediatrician at the National Institute of Allergy and Infectious Diseases in Bethesda, Md.

The study, involving 377 HIV-positive South African babies, 252 of whom were given antiretroviral drugs immediately, while the others weren’t given medication until symptoms appeared, found that infant mortality was reduced by 76 percent and HIV progression by 75 percent.

“When these early data were analyzed, it became clear that treating all infants at the earliest opportunity after diagnosis was the best course of action,” lead researcher Dr. Avy Violari, from the Comprehensive International Program of Research on AIDS said.

The babies who began treatment right away had less developmental problems than the other babies did because early treatment also protected their brain from HIV, the researchers found.

The new findings prompted the World Health Organization to change its guidelines, which had recommended delaying therapy until symptoms became apparent.                                                                                                                                               

The study was funded by the National Institute of Allergy and Infectious Diseases, the Department of Health of the Western Cape and Gauteng, South Africa, and by GlaxoSmithKline.