Cheap antibiotic works well for children with HIV

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A low-cost antibiotic which has performed well in tests should be given to all HIV children in developing countries to prevent infections such as pneumonia and reduce deaths, scientists said on Friday.

Dr Diana Gibb of Britain’s Medical Research Council said a trial involving HIV-infected children in Zambia was stopped early because it was so successful.

A daily dose of the drug co-trimoxazole nearly halved the death rate in youngsters taking it compared to those given a placebo.

"We believe that our results can be generalised to a policy that could be applied universally to children with clinical features of HIV infection in Africa and elsewhere,” Gibb said.

She and her team, who reported the findings in The Lancet medical journal, said they believe all children should receive the drug, regardless of their age or CD4 count - which measures immune system cells in the blood.

Children in the study were aged between 1 and 14 years.

HIV destroys the immune system and leaves the body vulnerable to a variety of life-threatening diseases, so-called opportunistic infections, such as tuberculosis or pneumonia.

“Co-trimoxazole in resource-limited settings where there are a lot of infections for children is certainly something that could have an impact on their quality of life, hospital admissions and mortality,” Gibb said in an interview.

Siobhan Crowley, a medical officer in the HIV/AIDS department of the World Health Organisation (WHO), welcomed the study and said poor countries should step up their use of the antibiotic in HIV children.

“This is great news for children infected with HIV because this is something that we can very widely promote in very resource-limited settings,” Crowley, who is responsible for HIV/AIDS-related pediatric and family care, told reporters in Geneva.

“We feel that in the light of this we are able to revise our current recommendations to be a little bit more proactive and strongly advocate the use of co-trimoxazole,” she added.

The researchers tested the drug in a trial of 541 children infected with HIV in Zambia. The youngsters were randomly selected to receive the treatment or a placebo and followed up for 19 months.

Twenty-eight percent of children in the drug group died, compared to 42 percent who had been given the placebo.

“Nutritional support and co-trimoxazole could definitely have an impact while waiting to see if anti-retrovirals can be rolled out,” Gibb added. Anti-retrovirals are a class of drugs that are used to fight HIV/AIDS.

She said it would cost just $10 a year to provide co-trimoxazole for a child.

About 38 million adults and children worldwide are living with HIV, according UNAIDS, the Joint United Nations Programme on HIV/AIDS. Most cases are in sub-Saharan Africa. 

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