To treat or not to treat? No longer a question.

ABSTRACT

Evaluation of Violari A, Paed FC, Cotton MF et al. Early antiretroviral therapy and mortality among HIV-infected infants. N. Engl. J. Med. 359(21), 2233-2244 (2008). Violari and her colleagues report the first randomized, open-label trial showing that early diagnosis and treatment with antiretroviral therapy decreases mortality and HIV progression in HIV-infected infants. The reality of implementing this recommendation into clinical care is challenging in resource-poor countries. Support for earlier diagnosis and access to antiretrovirals is improving, but access to HAART for all HIV-infected infants and children is often lacking. A change in care systems advocating early institution of antiretroviral therapy for all infants in these developing countries is clearly needed.