Published on November 25, 2014 by

Implications of causal modelling studies on the question of when to start antiretroviral treatment in young children

While in the past antiretroviral treatment (ART) for children aged 2-5 years was started only when the CD4 count or CD4% fell below a critical threshold, or a clinically severe event occurred, the new WHO 2013 guidelines recommend immediate treatment initiation regardless of the child’s immune status. Scientific evidence which can guide policies is sparse and conducting trials on the optimal timing of ART initiation is lengthy, costly, and ethically difficult. Instead, routinely captured observational data can be used to answer this question if the statistical analysis makes use of methods which allow a causal interpretation. One of these methods which allows causal interpretations is called “g-computation”.