- Infants born with HIV can be identified and started on antiretroviral therapy (ART) within hours of birth.
Why this matters
- Beginning ART after HIV diagnosis at birth is a growing focus of pediatric care.
- ART coverage for infants remains low in many areas, including in South Africa.
- 98% of infants with test-confirmed HIV infection were started on ART.
- Median age at ART start, from era 1 to era 3, dropped from 9 (interquartile range, 6-25) days to 2 (1-8) days.
- Addition of point-of-care (POC) testing allowed more frequent ART start within 48 hours of birth.
- Mortality probability by age 12 months was 19% (95% CI, 8%-39%) with additional POC testing vs 9% (3%-27%; P=.31) without it.
- 78% of infants started on ART at the study site were still in care at age 12 months.
- 5449 infants, South Africa, tested in 3 eras:
- Era 1, from September 2013: high-risk, HIV-exposed infants (n=201).
- Era 2, from June 2014: all HIV exposed infants offered lab-based PCR tests (n=798).
- Era 3, from October 2014: if available, POC tests added to lab-based testing (n=4450).
- Funding: NIH; others.
- Few with confirmed infection.
- Single-site with rapid lab-turnaround time.