Perinatal HIV
Diagnosis/Definition
Any child born to a mother who has tested positive for HIV requires an evaluation to exclude HIV infection.
Initial Diagnosis and Management
- Any child born to a woman infected with the human immunodeficiency virus is at risk for infection with HIV.
- All pregnant women should be screened during their pregnancy for HIV infection in order to detect the children at risk.
Ongoing Management and Objectives
If an ELISA for HIV antibodies is positive during the prenatal screening, the result should be confirmed by Western Blot. If this test is positive, the mother is considered infected with HIV and the child is at risk.
Indications for Specialty Care Referral
At the time that any expectant mother is identified as being positive for infection with HIV, Pediatric Infectious Disease (ID) should be immediately notified with a consult PRIOR to the birth of the infant so that tests on cord blood at birth can be properly processed for diagnosis of the infant.
The infant’s mother should also be referred to Adult ID to be placed on AZT prophylaxis during pregnancy as well as to provide ongoing care of maternal infection.
Criteria for Return to Primary Care
Once the infant has been identified as definitely uninfected with HIV (which would not be until 18 months of age), the child no longer requires Pediatric ID follow-up.
Children who are at risk for infection, but undetermined, need to be seen at ages 2 weeks, 1 month, 2 months, 4 months, 6 months, 12 months, 18 months and 2 years in the Pediatric ID clinic.
Any child at risk who is determined to be infected with HIV should not return to primary care other than for management of minor illnesses or well child care.
