Early Infant HIV Treatment in Botswana

Inclusion Criteria

• •1. Mother/guardian ≥18 years of age and able to provide informed consent
• •2. Gestational age at birth ≥35 weeks
• •3. Birth weight ≥2000 grams
• •4. Age is less than 7 days\*
• •5. HIV-infection identified by testing conducted within 96 hours after birth NOTE: HIV-infection is defined as DNA PCR positive on at least one specimen, with confirmation specimen either positive or pending\*\*
• •6. Ability to initiate ART within 7 days after birth
• •7. Eligible for ART through the Botswana government program
• •8. Ability to be followed in BHP clinic for up to 240 weeks from enrollment#
• •9. Blood samples collected and submitted for real-time safety lab evaluations; results may be pending at the time of entry.
• •* At least half of infants in the antepartum cohort must be \< 3 days at enrollment, including 3 of the first 6 infants enrolled.
• •* Participants will be offered extended follow-up for up to 576 weeks. However, willingness to participate in optional extended follow-up is not an inclusion criterion.
• •1. Mother/guardian ≥18 years of age and able to provide informed consent
• •2. Age is greater than 4 days and less than 57 days
• •3. HIV-negative within 96 hours after birth NOTE: HIV-negative is defined as HIV-negative by DNA PCR on a single specimen or HIV-negative on 2 separate confirmatory specimens following a re-test of an HIV-positive sample
• •4. HIV-positive between 96 hours and 56 days after birth NOTE: DNA PCR positive on at least one specimen with confirmation specimen either positive or pending repeat draw or result\*\*
• •5. Ability to initiate ART at enrollment
• •6. Eligible for ART through the Botswana government program
• •7. Ability to be followed in BHP clinic for ART for up to 240 weeks after enrollment#
• •8. Blood samples collected and submitted for real-time safety lab evaluations (results may be pending at the time of entry).
• •* An enrolled infant later determined to be HIV uninfected by confirmatory testing will end participation in the study and this enrollment will not be counted against the total number of enrollments planned.
• •* Participants will be offered extended follow-up for up to 576 weeks. However, willingness to participate in optional extended follow-up is not an inclusion criterion.
• •1. Mother/guardian ≥18 years of age and able to provide informed consent
• •2. 24-36 months of age
• •3. HIV-infection documented within 365 days after birth
• •4. ART initiated within the following timeframe based on timing of HIV-infection diagnosis \> 30-365 days after birth if HIV-infection diagnosed within 96 hours after birth OR \> 57-365 days after birth if infant was HIV-negative based on testing performed within 96 hours after birth (or if unknown HIV status \< 96 hours from birth) and then found to be HIV-positive based on testing performed between 96 hours and 365 days after birth.
• •5. After 6 months of ART, no more than one HIV RNA measurement \> 400 copies/mL