Technau KG, et al. - Performing this observational cohort study, researchers aimed to present the outcomes of HIV-infected infants identified at birth at Rahima Moosa Mother and Child Hospital in Johannesburg, South Africa. From September, 2013 (era 1), diagnostic HIV PCR tests at birth were offered to high-risk HIV-exposed infants only. From June, 2014 (era 2), laboratory-based diagnostic PCR tests were offered to all HIV-exposed infants. From October, 2014 (era 3), if staff availability allowed, point of care (POC) diagnostic PCR tests were done in addition. In total, 5449 HIV-exposed infants who were born between Sept 1, 2013, and June 30, 2016, were tested. They included 88 neonates with confirmed HIV infection in this study, of which 86 (98%) started antiretroviral therapy (ART). A decrease in median age at ART initiation from 9 days (IQR 6–25) in eras 1 and 2 to 2 days (1–8) in era 3 was noted. The probability of mortality by 12 months across the eras was 14% (95% CI 8–24) and did not differ by era. Findings thus suggest that despite starting ART in most infants in the cohort, continuously unacceptably high mortality was evident with suboptimal retention and viral suppression. This emphasize the urgent priorities for reducing mortality and improving retention and viral suppression