While a growing number of countries have adopted World Health Organisation guidelines recommending antiretroviral treatment for all children with HIV, more than half of children living with the virus in the highest burden countries in sub-Saharan Africa remain untreated.
A report notes that paediatric HIV treatment coverage nearly doubled between 2012 and 2016 as national policies began to incorporate WHO recommendations to expand paediatric antiretroviral treatment eligibility. Still, data across 20 countries receiving PEPFAR support showed 56% of children living with HIV under the age of 15 – an estimated 750,000 children – are not receiving the life-saving treatment that also prevents transmission of the virus.
The report, in the US Centres for Disease Control and Prevention’s Morbidity and Mortality Weekly Report notes that in addition to greatly reducing death rates among children younger than a year old, early antiretroviral treatment supports growth, neurological development, and long-term care outcomes for older children.
WHO guidelines, which in 2012 recommended antiretroviral treatment for all children with HIV under a year old, have reflected a growing body of knowledge about the benefits of early treatment over the years since.
In 2013, the agency recommended that all children with HIV under the age of five receive antiretroviral treatment, a recommendation that was adopted by 30% of the countries covered in the report* within that year, and 80% by the following year. By 2015, all of the countries had adopted the under-five guidelines, but by then the benefits of immediate treatment upon HIV diagnosis for all ages was demonstrated by the START study.
WHO adjusted its guidelines accordingly, and by the end of 2016, 65% of the countries covered in the report reflected that guidance in national policies establishing antiretroviral treatment eligibility for all children under 15 living with the virus.
CDC researchers used UNAIDS data to examine the impacts of the policies on actual paediatric treatment coverage, and found it ranged from about 5% of children with HIV receiving treatment in South Sudan, to 66% in Namibia. In 11 of 18 countries with data available, fewer than half of children living with the virus were receiving treatment in 2016.
The authors note that the findings show that increased case-finding, same-day care-linkage and community-based treatment retention, adherence, and tracking of paediatric patients must accompany prompt adoption of guidelines to improve treatment coverage and outcomes for children with HIV.
Amanda Burrage; Monita Patel; Kelsey Mirkovic; Eric Dziuban; Wondimu Teferi; Laura Broyles; Emilia Rivadeneira
[link url="http://sciencespeaksblog.org/2018/05/17/more-than-half-of-children-living-with-hiv-still-without-treatment-in-high-burden-pepfar-supported-southern-african-countries/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+ScienceSpeaksHivTbNews+(Science+Speaks:+Global+ID+News)"]Science Speaks blog[/link]
[link url="https://www.cdc.gov/mmwr/volumes/67/wr/mm6719a4.htm?s_cid=mm6719a4_w"]CDC’s Morbidity and Mortality Weekly report[/link]