Title

When HIV or ART hits you early: Children born to HIV mothers living with HIV (CME)

Code

SY17

Session Type

Symposium

Track

Track B: Clinical science

Channel

Channel 4

Date Time

19 July 11:00- 11:50

Local Date Time

11:00 - 11:50 W. Europe Daylight Time

Moderator:

Lynda STRANIX-CHIBANDA, University of Zimbabwe, Zimbabwe

As the HIV epidemic has matured, notable progress has been made in reducing infant HIV acquisition. Yet children who are HIV-exposed and uninfected experience higher risk of poorer health and developmental outcomes than children born to women who are not living with HIV. This session will investigate paediatric HIV therapy, intrauterine ART exposure and its consequences, and the lifelong impact on adults born with HIV.

2 min	Introduction Lynda STRANIX-CHIBANDA, University of Zimbabwe, Zimbabwe

10 min	Pediatric HIV therapy Philippa MUSOKE, MUJ-HU Research Collaboration, Uganda

10 min	Intrauterine ART exposure and consequences Madeleine Bunders BUNDERS, Leibniz-Institute for Experimental Virology, Germany

10 min	What lifelong really means: Adults born with HIV Allison AGWU, Johns Hopkins University School of Medicine, United States	PDF

18 min	Live Q&A Madeleine Bunders BUNDERS, Leibniz-Institute for Experimental Virology, Germany Allison AGWU, Johns Hopkins University School of Medicine, United States Philippa MUSOKE, MUJ-HU Research Collaboration, Uganda Lynda STRANIX-CHIBANDA, University of Zimbabwe, Zimbabwe

AUTHOR

Christoph D. Spinner

SUMMARY

Although HIV discussions focusses often on adults living with HIV, globally more than 1.7 million children are living with HIV. The session focussed on an update of the global situation, the improvements to reduce mortality by ART in children with HIV and further implications and needs.

HIGHLIGHTS

More than 30% of all children with HIV globally live in South Africa and Nigeria and more than 50% in Africa. While antiviral therapy (ART) reduced the HIV-related mortality significantly, global ART coverage in children is poor (approximately 53%). Moreover, the mortality in pre- and post-ART area has almost not changed and is the highest in children with CD4 cells < 200 /µl. With the availability of the first INSTI-based ART in children, significant achievements in outcomes of children were observed within the ODYSSEY-study, presented at CROI earlier this year. Nevertheless, the role of ART exposure and HIV exposure in uninfected children needs further research and many questions are still open. Novel data on changes in metabolomics and metabolic dysregulation have been presented and a fruitful discussion followed. Further research is needed to study the implication of livelong ART and the multifactorial impact and outcomes of children born with HIV once aging.

CRITICAL ASSESSMENT

While HIV itself was described in the early 1980s, the first infant born with HIV was dated to 1977. Although nelfinavir paved the way for ART in children in 1996, a major improvement has been reached with the availability of INSTIs in children. However, there is an urgent need to improve the safety and tolerability of ART options in children.