↵a Although there are no definitive data in infants to show pharmacokinetic equivalence or equal therapeutic efficacy of administration of double the standard oral ZDV dose twice daily, for term infants administration of ZDV 4 mg/kg per dose twice daily instead of 2 mg/kg per dose every 6 hours may increase adherence to the regimen and could be considered when there are concerns about adherence to drug administration to the infant.26,77,78
Scenario: infant born to an HIV-infected mother taking highly active ARV therapy since second trimester, virus load undetectable the week before delivery, and mother received 3 hours of ZDV intravenously before delivery.
↵b If any positive HIV-1 NAAT result, test is promptly repeated to confirm the diagnosis of HIV-1 infection (see “Management if an HIV-1 Virologic Test Result Is Positive”).
↵c Some experts recommend checking hemoglobin level or complete blood cell count at 2 weeks and/or 4 weeks of age. These more frequent measurements might be warranted for preterm infants or if the baseline hemoglobin level is low.
↵d If no testing was performed before this or only a single test was performed between 14 days and 6 weeks of age, start PCP prophylaxis at this point until HIV infection is presumptively excluded.
↵e If PCP prophylaxis was started because of indeterminate HIV-1 infection status from incomplete previous testing, it can be stopped when this 8-week test result is negative.
↵f Many experts confirm the absence of HIV-1 infection with a negative HIV-1 antibody assay result at 12 to 18 months of age.