NOVEMBER 20, 2008 | Avy Violari, F.C.Paed., Mark F. Cotton, M.Med., Ph.D., Diana M. Gibb, M.D., Abdel G. Babiker, Ph.D., Jan Steyn, M.Sc., Shabir A. Madhi, F.C.Paed., Ph.D., Patrick Jean-Philippe, M.D., and James A. McIntyre, F.R.C.O.G., for the CHER Study Team
The Children with HIV Early Antiretroviral Therapy (CHER) trial investigated the optimal timing and duration of antiretroviral therapy in HIV-infected infants. Infants aged 6 to 12 weeks with a CD4 percentage of 25% or more were randomly assigned to receive antiretroviral therapy when the CD4 percentage fell below 20% or clinical criteria were met (deferred therapy group) or to immediate initiation of limited antiretroviral therapy until 1 or 2 years of age (early therapy groups). The results showed that early antiretroviral therapy reduced early infant mortality by 76% and HIV progression by 75%. Specifically, 16% of infants in the deferred-therapy group died compared to 4% in the early-therapy groups, and 26% of infants in the deferred-therapy group progressed to advanced stages of disease compared to 6% in the early-therapy groups. The study concluded that early antiretroviral therapy is effective in reducing mortality and disease progression in HIV-infected infants, supporting the recommendation for early initiation of antiretroviral therapy regardless of CD4 percentage or count.The Children with HIV Early Antiretroviral Therapy (CHER) trial investigated the optimal timing and duration of antiretroviral therapy in HIV-infected infants. Infants aged 6 to 12 weeks with a CD4 percentage of 25% or more were randomly assigned to receive antiretroviral therapy when the CD4 percentage fell below 20% or clinical criteria were met (deferred therapy group) or to immediate initiation of limited antiretroviral therapy until 1 or 2 years of age (early therapy groups). The results showed that early antiretroviral therapy reduced early infant mortality by 76% and HIV progression by 75%. Specifically, 16% of infants in the deferred-therapy group died compared to 4% in the early-therapy groups, and 26% of infants in the deferred-therapy group progressed to advanced stages of disease compared to 6% in the early-therapy groups. The study concluded that early antiretroviral therapy is effective in reducing mortality and disease progression in HIV-infected infants, supporting the recommendation for early initiation of antiretroviral therapy regardless of CD4 percentage or count.