Global Prevention and Treatment of Pediatric HIV-1 Infection

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Global Prevention and Treatment of Pediatric
HIV-1 Infection

• Katherine Luzuriaga, M.D.
• Professor
• Pediatrics Molecular Medicine
• UMMS

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Pediatric HIV/AIDS 2005

• 2.5 million infants at risk for MTCT.
• 620,000 newly infected per year.
• Industrialized countries ART have markedly
  decreased MTCT and pediatric HIV-related
  morbidity and mortality.
• Resource limited settings Simplified ART
  regimens can prevent MTCT but implementation has
  been difficult half of HIV infected children die
  by their second birthday.

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International Clinical Trials

• Prevention of MTCT
• PACTG Phase I-III Nevirapine Trials
• South Africa South African Intrapartum
  Nevirapine Trial
• IMPAACT International Pediatric Adolescent and
  Adult AIDS Clinical Trials Group
• Pediatric Treatment
• Cambodia Modified DOT Trial in Children
• Dr. Sam Sophan, National Pediatric Hospital,
  Phnom Penh
• IMPAACT

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Pediatric HIV-1 Vaccine Rationale

• ART efficacy will be limited by cost, logistical
  issues, and the emergence of resistance.
• Neonatal immunization may not only protect
  against perinatal and breast milk HIV-1
  transmission, but may also form the basis for
  lifetime immunity.
• Neonatal immunizations utilize existing
  infrastructure for delivery of childhood vaccines.

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MVA/Fowlpox Vaccine Milestones
Date Milestone
1996 Genes to Therion
2002 Clinical grade vaccines available
2003 Pre-clinical tox studies completed
November, 2004 Phase I MVA/FP in HIV seronegative adults (HVTN 055)
August, 2005 Phase I MVA/FP in HIV seropositive youth (PACTG 1059)
June, 2006 Phase I/II Early Therapy MVA/FP vaccines in HIV positive infants (US Brazil)
January, 2007 Phase I/II MVA/FP in infants born to HIV positive women (IMPAACT)