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Global Health
October 16, 2013

Early Initiation of Short Course of ART Beneficial in Infants With HIV

JAMA. 2013;310(15):1551. doi:10.1001/jama.2013.280606

Infants infected with HIV who begin an immediate time-limited course of antiretroviral treatment (ART) had better clinical and immunological outcomes with less ART exposure than infants in whom ART was deferred, according to final results from the Children with HIV Early Antiretroviral trial (Cotton MF et al. Lancet. doi:10.1016/S0140-6736[13]61409-9 [published online August 22, 2013]).

At 2 South African trial sites, an international group of researchers carried out a randomized controlled trial of 377 asymptomatic infants younger than 12 weeks who were infected with HIV without severe depletion of CD4 T cells. The infants were assigned to 1 of 3 groups. Two groups received immediate ART, one for 40 weeks and the other for 96 weeks, with treatment interrupted and only resumed if CD4 counts decreased. In the third group, ART was deferred until signs of illness or a decrease in CD4 counts was seen.