Bacteremia contributes to morbidity of HIV-infected children. In a randomized controlled trial evaluating trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis, 47 bacteremias were detected. The incidence rate of bacteremia increased in the first 3 months after starting combination antiretroviral therapy (cART), but decreased by 74% once children were established on cART for more than 3 months. Children should be prioritized for early cART.
From the *Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; †Department of Paediatrics and Child Health, Tygerberg Children's Hospital, Stellenbosch University, Cape Town, South Africa; ‡National Health Laboratory Services, University of Cape Town, Cape Town, South Africa; and §Biostatistics Unit, Medical Research Council, Cape Town, South Africa.
Accepted for publication April 20, 2011.
Supported in part by a fellowship from Fogarty International Center/USNIH (2 D 43 TW000010–20-AITRP) (to D.M.l.R.); the Rockefeller Foundation, US; the MRC South Africa; the National Research Foundation, South Africa; The South African Thoracic Society; and the Department of Health, South Africa.
D.M.l.R. was involved in analysis and wrote the manuscript. H.J.Z. and M.F.C. conceived the study, wrote the protocol and grant for funding, and supervised the study and manuscript. S.M.l.R. was a trial physician and assisted with data analysis and drafting the manuscript. A.W. contributed to the laboratory methods and interpretation. C.J.L. contributed to study design, was responsible for the randomization list and did initial statistical analysis. All authors approved the final manuscript.
The authors have no other funding or conflicts of interest to disclose.
Address for correspondence: David le Roux, MB ChB, MPH, FCPaed, PO Box 159, Newlands, 7725 Cape Town, South Africa. E-mail: DrDaveleRoux@gmail.com.