Malnutrition and Antiretroviral Timing in Children with HIV (MATCH)

INTERVENTION: Delayed Arm Early Arm CONDITION: ; HIV/AIDS HIV/AIDS PRIMARY OUTCOME: anthropometric response (BMIZ/WAZ/HAZ) immunological response Virological Response (VL<1000c/ml) SECONDARY OUTCOME: adverse events/IRIS events mortality INCLUSION CRITERIA: 1. Age: 1 months ‐ 12 years 2. HIV infection as defined as a positive ELISA or Rapid HIV test in children over 18 months or a positive DNA PCR in children under 18 months. 3. ART‐naïve except for antiretroviral prophylaxis given for PMTCT. 4. Severe acute malnutrition (SAM) as defined by WHO criteria: Weight‐for‐length 3 z‐scores below the WHO growth standards median or Mid‐upper arm circumference (MUAC) < 115 mm with/without peripheral edema. 5. Eligible for initiation of HAART by the SA national treatment guidelines