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Babies with suspected HIV should receive antiretrovirals immediately

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Babies born with the HIV virus should be started on antiretroviral treatment as soon as they are diagnosed, say researchers who studied 377 HIV-positive infants.

Starting antiretroviral therapy immediately – rather than waiting for the baby to develop HIV symptoms or for their CD4 blood cell count to drop – reduced their chance of dying by 76%, the researchers said.

‘These data provide strong support for the initiation of antiretroviral therapy from an early age, regardless of the CD4 percentage or count,’ the authors said.

‘A good programme for the prevention of mother-to-child transmission of HIV-1, encompassing early diagnosis in infants, is fundamental to the success of any early antiretroviral-therapy strategy,’ the added.

The study is a joint collaboration between hospitals in South Africa and the UK’s Medical Research Council and the US National Institutes of Health.

New England Journal of Medicine (2008) 359: 2233-2244

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