Paediatric HIV: Progress on Prevention, Treatment and Cure

doi:10.1007/s40124-015-0087-7

. 2015 Sep;3(3):219-229.

doi: 10.1007/s40124-015-0087-7. Epub 2015 Jul 22.

Paediatric HIV: Progress on Prevention, Treatment and Cure

Maria H Kim¹, Saeed Ahmed¹, Elaine J Abrams²

Affiliations

¹ Baylor College of Medicine, Department of Pediatrics, Section of Retrovirology, Houston, Texas, USA ; Baylor College of Medicine-Abbott Fund Children's Clinical Center of Excellence, Lilongwe, Malawi.
² ICAP-Columbia University, Mailman School of Public Health, New York NY, USA ; College of Physicians & Surgeons, Columbia University, New York, NY, USA.

PMID: 26709366
PMCID: PMC4687896
DOI: 10.1007/s40124-015-0087-7

Paediatric HIV: Progress on Prevention, Treatment and Cure

Maria H Kim et al. Curr Pediatr Rep. 2015 Sep.

. 2015 Sep;3(3):219-229.

doi: 10.1007/s40124-015-0087-7. Epub 2015 Jul 22.

Authors

Maria H Kim¹, Saeed Ahmed¹, Elaine J Abrams²

Affiliations

¹ Baylor College of Medicine, Department of Pediatrics, Section of Retrovirology, Houston, Texas, USA ; Baylor College of Medicine-Abbott Fund Children's Clinical Center of Excellence, Lilongwe, Malawi.
² ICAP-Columbia University, Mailman School of Public Health, New York NY, USA ; College of Physicians & Surgeons, Columbia University, New York, NY, USA.

PMID: 26709366
PMCID: PMC4687896
DOI: 10.1007/s40124-015-0087-7

Abstract

Purpose of review: This review provides an update on current developments with prevention, treatment and cure strategies in the field of pediatric HIV.

Recent findings/summary: There has been tremendous progress in the prevention and treatment of pediatric HIV infection. With new strategies for prevention of mother-to-child transmission, we are growing ever closer towards elimination of pediatric HIV, though challenges with retention of pregnant woman and their HIV-exposed infants remain. Ongoing vigilance regarding the potential hazards of in utero ART exposure to infants continues with no significant alarms yet identified. Though cure has not been achieved, evidence of the impact of early treatment on reducing HIV-1 reservoir size with subsequent prolonged remission has enlivened efforts to rapidly identify and treat HIV-infected newborns. There is an increasing array of treatment options for pediatric patients and reassuring evidence regarding long-term complications of ART. Unfortunately, despite evidence suggesting the benefit of early treatment, timely identification and treatment of children remains a challenge. Better strategies for effective case-finding and engagement in care are urgently needed in addition to an improved understanding of how to retain HIV-positive children and adolescents on treatment. However, further emboldened by recent international commitments and robust global support, the future is hopeful.

Keywords: PMTCT; Pediatric HIV; review.

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Conflict of interest statement

COMPLIANCE WITH ETHICS GUIDELINES

Conflicts of Interest

Maria H. Kim, Saeed Ahmed, and Elaine J. Abrams declare they have no conflict of interest.

Figures

**Figure 1**
New and current HIV infections among children globally

**Figure 2**
Estimated AIDS-related deaths and HIV prevalence among adolescents globally

See this image and copyright information in PMC

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References

1. Townsend CL, Byrne L, Cortina-Borja M, et al. Earlier initiation of ART and further decline in mother-to-child HIV transmission rates, 2000–2011. Aids. 2014;28(7):1049–1057. Analysis of mother-to-child HIV transmission rates over time using population-based surveillance data in the UK and Ireland demonstrated a continued decline in MTCT from 2006 to 2011. The authors delineated the trajectory of viral suppression during pregnancy. Low transmission rates were associated with a variety of factors including earlier ART initiation.
1. Bamford A, Lyall H. Paediatric HIV grows up: recent advances in perinatally acquired HIV. Arch Dis Child. 2015;100(2):183–188. Description of current status of pediatric HIV in the UK and Ireland including the epidemiology, perinatal prevention efforts, and treatment outcomes.
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1. Cotton MF, Rabie H. Impact of earlier combination antiretroviral therapy on outcomes in children. Curr Opin HIV AIDS. 2015;10(1):12–17. Review of the findings of studies and case reports of early ART initiation during infancy as well as challenges and implications of treatment initiation close to the time of birth.

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[1] Townsend CL, Byrne L, Cortina-Borja M, et al. Earlier initiation of ART and further decline in mother-to-child HIV transmission rates, 2000–2011. Aids. 2014;28(7):1049–1057. Analysis of mother-to-child HIV transmission rates over time using population-based surveillance data in the UK and Ireland demonstrated a continued decline in MTCT from 2006 to 2011. The authors delineated the trajectory of viral suppression during pregnancy. Low transmission rates were associated with a variety of factors including earlier ART initiation.

[2] Townsend CL, Byrne L, Cortina-Borja M, et al. Earlier initiation of ART and further decline in mother-to-child HIV transmission rates, 2000–2011. Aids. 2014;28(7):1049–1057. Analysis of mother-to-child HIV transmission rates over time using population-based surveillance data in the UK and Ireland demonstrated a continued decline in MTCT from 2006 to 2011. The authors delineated the trajectory of viral suppression during pregnancy. Low transmission rates were associated with a variety of factors including earlier ART initiation.

[3] Bamford A, Lyall H. Paediatric HIV grows up: recent advances in perinatally acquired HIV. Arch Dis Child. 2015;100(2):183–188. Description of current status of pediatric HIV in the UK and Ireland including the epidemiology, perinatal prevention efforts, and treatment outcomes.

[4] Bamford A, Lyall H. Paediatric HIV grows up: recent advances in perinatally acquired HIV. Arch Dis Child. 2015;100(2):183–188. Description of current status of pediatric HIV in the UK and Ireland including the epidemiology, perinatal prevention efforts, and treatment outcomes.

[5] UNAIDS. The Gap Report. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS; 2014. - PubMed

[6] UNAIDS. The Gap Report. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS; 2014. - PubMed

[7] UNAIDS. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS; 2014. 2014 Progress Report on the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive.

[8] UNAIDS. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS; 2014. 2014 Progress Report on the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive.

[9] Cotton MF, Rabie H. Impact of earlier combination antiretroviral therapy on outcomes in children. Curr Opin HIV AIDS. 2015;10(1):12–17. Review of the findings of studies and case reports of early ART initiation during infancy as well as challenges and implications of treatment initiation close to the time of birth.

[10] Cotton MF, Rabie H. Impact of earlier combination antiretroviral therapy on outcomes in children. Curr Opin HIV AIDS. 2015;10(1):12–17. Review of the findings of studies and case reports of early ART initiation during infancy as well as challenges and implications of treatment initiation close to the time of birth.

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Paediatric HIV: Progress on Prevention, Treatment and Cure

Affiliations

Paediatric HIV: Progress on Prevention, Treatment and Cure

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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