Published online December 29, 2008
PEDIATRICS Vol. 123 No. 1 January 2009, pp. 175-187 (doi:10.1542/peds.2008-3076)
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CLINICAL REPORT

Evaluation and Management of the Infant Exposed to HIV-1 in the United States

Peter L. Havens, MD, Lynne M. Mofenson, MD and the Committee on Pediatric AIDS

The pediatrician plays a key role in the prevention of mother-to-child transmission of HIV-1 infection. For infants born to women with HIV-1 infection identified during pregnancy, the pediatrician ensures that antiretroviral prophylaxis is provided to the infant to decrease the risk of acquiring HIV-1 infection and promotes avoidance of postnatal HIV-1 transmission by advising HIV-1–infected women not to breastfeed. The pediatrician should perform HIV-1 antibody testing for infants born to women whose HIV-1 infection status was not determined during pregnancy or labor. For HIV-1–exposed infants, the pediatrician monitors the infant for early determination of HIV-1 infection status and for possible short- and long-term toxicity from antiretroviral exposures. Provision of chemoprophylaxis for Pneumocystis jiroveci pneumonia and support of families living with HIV-1 by providing counseling to parents or caregivers are also important components of care.

Key Words: human immunodeficiency virus • HIV-1 • perinatal transmission • antiretroviral prophylaxis • diagnosis • infant

Abbreviations: MTCT—mother-to-child transmission • ARV—antiretroviral • AAP—American Academy of Pediatrics • PCP—Pneumocystis jiroveci pneumonia • CDC—Centers for Disease Control and Prevention • ZDV—zidovudine • TB—tuberculosis • NAAT—nucleic acid amplification test • PCR—polymerase chain reaction • BCG—bacille Calmette-Guérin • TST—tuberculin skin test


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The following policy statement has been revised:

Evaluation and Treatment of the Human Immunodeficiency Virus-1--Exposed Infant
, , and
Pediatrics 114: 497-505. [Full Text]



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