Highlight
Four principal takeaways from IMPAACT P1115:
– Initiating three‑drug ART within 48 hours of birth in infants with in‑utero HIV‑1 can lead to ART‑free remission of at least 48 weeks in a subset of carefully selected children.
– Of 54 neonates with in‑utero infection enrolled, 6 met stringent criteria and underwent analytical treatment interruption (ATI); 4 of these maintained HIV‑1 RNA undetectable off ART for ≥48 weeks (67% of the ATI group; exact 95% CI 22–96).
– Stringent entry criteria led to a small ATI cohort (11% of enrolled infants); when denominated across all enrolled children, sustained remission was rare (4/54 ≈ 7.4%), underscoring selection effects.
– ATI carried manageable risks: viral rebound occurred in three children (two early, one late), all re‑suppressed on ART, and acute retroviral symptoms were mild and reversible with ART resumption.
