Published on Lancet HIV
April 26, 2021

Urgent antiretroviral therapy (ART) among hospitalized HIV-infected children may accelerate recovery or worsen outcomes due to immune reconstitution, according to an unblinded randomized controlled trial.

Researchers compared urgent versus post-stabilization ART among hospitalized HIV-infected children. While the benefits of initiating ART before symptomatic disease in HIV-infected children are well known, the benefit of accelerated ART initiation during hospitalization for severe illness is undefined.

About 250 HIV-infected, ART-naïve children, aged from 0 to 12 years old and eligible for ART, were randomized in a 1:1 ratio to receive ART within 48 hours (urgent arm) or 7 to 14 days (post-stabilization arm). Children with suspected or confirmed central nervous system (CNS) infection were excluded. The researchers followed children for six months for primary outcomes: mortality, drug toxicity, and immune reconstitution inflammatory syndrome (IRIS).

Published in final edited form as: Lancet HIV. 2018 January ; 5(1): e12–e22.
doi:10.1016/S2352-3018(17)30167-4.

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Urgent Versus Post-Stabilization Antiretroviral Treatment (ART) in Hospitalized Children: A Randomized Controlled Trial