HIV AIDS infection in infants
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Recommendations
Diagnosis of HIV Infection in Infants
- Virologic assays that directly detect HIV must be used to diagnose HIV infection in infants younger than 18 months (AII). HIV antibody testing cannot establish HIV infection in this age group because maternal HIV antibodies may persist and interfere with the interpretation of a positive HIV antibody test.
- Virologic diagnostic testing is recommended in infants with known perinatal HIV exposure at ages 14–21 days, 1–2 months, and 4–6 months ( AII ).
- Virologic diagnostic testing at birth should be considered for infants at high risk of HIV infection (BIII).
- HIV DNA polymerase chain reaction (PCR) and HIV RNA assays are recommended as preferred virologic assays (AII).
- Confirmation of HIV infection should be based on two positive virologic tests obtained from separate blood samples (AI).
- Definitive exclusion of HIV infection (in the absence of breastfeeding) should be based on at least two negative virologic tests (one at >1 month and one at ≥4 months of age) (AII).
- Some experts confirm the absence of HIV infection at 12–18 months of age in infants with prior negative virologic tests by performing an antibody test to document loss of maternal HIV antibodies (BIII).
- In children ≥18 months of age, HIV antibody assays alone can be used for diagnosis (AII)