The evidence supporting early initiation of ART regardless of CD4 count has “several important consequences” related to managing tuberculosis in this population, according to Amita Gupta, MD, MHS, of Johns Hopkins University School of Medicine.
Gupta reviews recent investigations that support the role of early ART in TB prevention, including the TEMPRANO trial, the HPTN 052 study and the Strategic Timing of AntiRetroviral Treatment, or START, trial. ART is “a very powerful prevention tool for reducing morbidity and mortality related to TB,” she said.
Research also supports the use of isoniazid preventive therapy in children with HIV, although its use in children aged 1 year or under is not yet fully elucidated.
“We are clearly recommending the ART component for young children, but the question of whether to use [isoniazid] in really young infants is still not entirely clear,” Gupta said.