Antiretroviral therapy during infancy: essential intervention for resource-limited settings.
EVALUATION OF: Prendergast A, Mphatswe W, Tudor-Williams G et al. Early virological suppression with three-class antiretroviral therapy in HIV-infected African infants. AIDS 22, 1333-1343 (2008). There is limited information regarding the outcome of infants treated with highly active antiretroviral therapy (HAART) in middle- and low-income countries. The mean/median age of children enrolled on HAART in these countries is generally high; however, it is acknowledged that untreated HIV-infected children under 2 years of age, including infected infants, are an extremely vulnerable group. This article assessed the findings of a recently published paper describing the outcome of 63 infants randomized to commence immediate or deferred HAART in a resource-poor setting and documented favorable short-term outcome in both groups, with correspondingly high adherence rates. The recent change in global treatment guidelines, recommending that all HIV-infected infants should be commenced on HAART soon after diagnosis, irrespective of their clinical status and/or immunological severity, is discussed in relation to the key findings of the article.
Paediatric Infectious Diseases Unit, Red Cross Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Rondebosch, Cape Town, South Africa. brian.eley@uct.ac.za
Brian S
BS
Eley