What are the benefits of starting highly active antiretroviral therapy (HAART) early in pediatric HIV infection?

Updated: Mar 05, 2020
  • Author: Delia M Rivera, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

In a study of HIV-1-infected, highly active antiretroviral therapy (HAART)-naive children, Yin et al found that beginning HAART at younger ages and healthier CD4 levels results in better immune recovery. [1, 2] In all, 72% of children who were immunosuppressed at baseline recovered to normal within 4 years after initiating HAART therapy. Compared with children with severe immunosuppression, more children with mild immunosuppression (+36%) or advanced immunosuppression (+20.8%) recovered a normal CD4 percentage.

For every 5-year increase in baseline age, the proportion of children who achieved a normal CD4 percentage fell by 19%. [2] Combining age effects and baseline CD4 percentage resulted in more than 90% recovery when HAART was initiated in children with mild immunosuppression at any age or advanced immunosuppression at an age younger than 3 years. Most of the immunologic benefits of HAART remained significant at 4 years.


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