Antiretroviral prophylaxis in infants born to mothers with HIV in resource-limited settings

This algorithm reflects the World Health Organization recommendations for infant antiretroviral prophylaxis to prevent vertical transmission of HIV infection. Guidance may vary by country; clinicians should refer to national guidelines when applicable. Prophylaxis should start as soon as possible after birth, preferably within 6 to 12 hours. Refer to other UpToDate content for dosing details. In addition to infant prophylaxis, initiation of lifelong ART is recommended for all pregnant and breastfeeding females with HIV. For management of infant antiretroviral prophylaxis in breastfed infants beyond the first 72 hours of life, refer to UpToDate content on prevention of HIV through breastfeeding.

HIV: human immunodeficiency virus; ART: antiretroviral therapy; VL: viral load.

* If the mother cannot tolerate or declines ART, then the infant should continue nevirapine prophylaxis throughout the duration of breastfeeding, until one week following breastfeeding cessation (if nevirapine is not tolerated, daily lamivudine can be used).

Adapted from: Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. World Health Organization 2021. Available at: https://www.who.int/publications/i/item/9789240031593 (Accessed on April 13, 2022).

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Antiretroviral prophylaxis in infants born to mothers with HIV in resource-limited settings