Is Option B+ the Best Choice?

Journal Article
  • Scott Kellerman
  • Jonathan S. Jay
  • Jonathan D. Quick
The Lancet
381 (9874) (April 13, 2013): 1273.
Letter to the editor  Anna Coutsoudis and colleagues worry that international organisations have too hastily endorsed a strategy to provide lifelong triple antiretroviral therapy (ART), irrespective of CD4 count, to pregnant women with HIV in high-burden countries. This strategy for preventing mother-to-child transmission is called Option B+. It was pioneered in Malawi,#bib2" id="back-bib2">2 where the lack of CD4 testing resources impeded effective rollout of WHO Options A or B. Without timely CD4 results, both WHO regimens risk withholding therapy from women who need it. Other countries share this limitation. Yet even where all three regimens are feasible, Option B+ might be best.