Ongoing High Prevalence of Severe Immune Suppression Among Children in South Africa

Among children in Southern Africa severe immune suppression (SIS) has declined, but most continue to initiate antiretroviral therapy (ART) with SIS. Using data from South Africa, we describe SIS at ART start and on ART between 2007 and 2020, among children 9 months without a recorded visit. We defined SIS according to age and CD4%/cell count. A multistate model was used to estimate transition probabilities between 5 states: SIS on ART; Stable, not SIS; Early Gap, commencing