Fig. 4: Lack of viral rebound in two male subjects following significant periods of ART non-adherence.

a Male subject 1633-1 received no ART for at least 7 weeks at 12–14 months’ age: pharmacy records show that the aunt of the child did not collect any ART medication for 2 months following the return of the child’s mother to work 12 m after the child’s birth. ART was restarted 7 days prior to the viral load test at 15 m. Undetectable DNA viral loads are shown as 5 HIV DNA cpm PBMC. Only the 18 m timepoint was above the limit of detection (DNA load 21 cpm PBMC). b Male subject 0114-1: none of the drugs prescribed were detected in plasma tested over a 7-month period (age 5–12 months). At age 15 months and 18 months, only 1 and 2 of the 4 drugs prescribed were detected at therapeutic levels, respectively. Undetectable DNA viral loads are shown as 5 HIV DNA cpm PBMC. Only the baseline timepoint (at 7 days’ age) was above the limit of detection (DNA load 25 cpm PBMC). c Gag was amplified from plasma from the baseline sample from both these mother-child pairs and the sequences determined clustered on a phylogenetic tree, consistent with HIV infection and mother-to-child transmission in each case. Diagnosis in these cases, as in all the in utero-infected infants in the cohort, was determined by 2 or more tests from separate blood samples detecting HIV nucleic acids.