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Because of the high risk for rapid progression
of HIV disease, many experts would treat all HIV-infected infants <12 months
old, regardless of clinical, immunologic, or virologic parameters. Other experts would treat all infected infants <6 months old, and use clinical and immunologic parameters and assessment of adherence issues for decisions regarding initiation of therapy in infants 6 to 12 months of age. Some intriguing data suggest that the risk of disease progression during the first 2 years of life may be related to maternal clinical, immunologic, and virologic HIV disease status during pregnancy, with more rapid progression in infants born to women with more advanced HIV disease [84]. |