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Human Immunodeficiency Virus...
Pneumocystis jiroveci Infections
PEDIATRICS Vol. 114 No. 2 August 2004, pp. 497-505

CLINICAL REPORT

Evaluation and Treatment of the Human Immunodeficiency Virus-1—Exposed Infant

Susan M. King, MD, MSc Committee on Pediatric AIDS, Canadian Paediatric Society, Infectious Diseases and Immunization Committee

In developed countries, care and treatment are available for pregnant women and infants that can decrease the rate of perinatal human immunodeficiency virus type 1 (HIV-1) infection to 2% or less. The pediatrician has a key role in prevention of mother-to-child transmission of HIV-1 by identifying HIV-exposed infants whose mothers' HIV infection was not diagnosed before delivery, prescribing antiretroviral prophylaxis for these infants to decrease the risk of acquiring HIV-1 infection, and promoting avoidance of HIV-1 transmission through human milk. In addition, the pediatrician can provide care for HIV-exposed infants by monitoring them for early determination of HIV-1 infection status and for possible short- and long-term toxicities of antiretroviral exposure, providing chemoprophylaxis for Pneumocystis pneumonia, and supporting families living with HIV-1 infection by providing counseling to parents or caregivers.

Key Words: HIV-1 • mother-to-child transmission • HIV-exposed infants • antiretroviral • diagnosis

Abbreviations: HIV, human immunodeficiency virus • AAP, American Academy of Pediatrics • EIA, enzyme immunoassay • ZDV, zidovudine • NVP, nevirapine • 3TC, lamivudine • TB, tuberculosis • PCR, polymerase chain reaction • PCP, Pneumocystis pneumonia




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