Paediatric treatment

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Paediatric treatment
Paediatric treatment (Part II)
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Introduction

We started our first clinical trial that allowed triple therapy for HIV infected children in 1998. In January 2001 we established our first programme to provide access to Antiretroviral therapy for mothers and children identified through our VCT services (funded by FSTI). The paediatric division has been able to perform multicentre trials through the collaboration with the “CIPRA-SA collaborative programme” and the “IMPAACT network” (Infant Maternal Paediatric Adolescent Clinical AIDS Clinical Trials Group).

Dr Avy Violari heads the paediatric treatment division

Current clinical trials:

1) CHER Trial is part of CIPRA SA collaborative programme:The CHER trial addresses the question of whether early initiation of antiretroviral therapy (ART) for a limited period soon after primary infection and during the time when the immune system is most immature in young infants could result in long-term benefit and delay the time when life-long ART has to be commenced.

Interim results reviewed by the DSMB on June 20th 2007, found convincing evidence that early ART was superior to deferred and recommended unblinding of those results.
The CHER trial has already made a major contribution to treatment policies. On 28 February 2008, the USA Working Group on Antiretroviral Therapy and Medical Management of HIV-infected children amended their guidelines to recommend that all HIV-infected children under 12 months of age receive immediate ART (http://AIDSinfo.nih.gov). On 13th June 2008, the Technical Reference Group of the WHO made an identical recommendation (www.who.int).

Closely linked to the Cher Trial,using the same study design and participants, are the following projects

2) CIPRA-SA Project 4: This study looks at the effect of ART on antibody production to the conjugated Streptococcus pneumoniae and Haemophilus influenzae.

3) Paediatric Immune Correlates of Early Anti-HIV Therapy: This is an Immunology study in collaboration with the Wistar Institute and examines the effects of ART on the functional reconstitution/maturation of the innate/adaptive immune system and its interplay with disease progression to identify correlates of delayed disease progression and targets for immuno-therapy. The short-term goal, is to assess the innate and adaptive immunological correlates and possible benefits of early and delayed therapy in infants infected with HV at birth.