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تعداد آیتم قابل مشاهده باقیمانده : -23 مورد

Virologic testing schedules for infants exposed to HIV according to perinatal HIV transmission risk

Virologic testing schedules for infants exposed to HIV according to perinatal HIV transmission risk
Risk category Definition Testing schedule
High-risk formula-fed infants: Infants born to mothers with HIV who:
  • Had viremia* (HIV RNA ≥50 copies/mL) after 20 weeks gestation
  • Had acute or recent HIV during pregnancy
  • Were diagnosed with HIV in labor or postpartum
 Perform virologic testing with NAT at the following ages:
  • Birth
  • 14 to 21 days
  • 1 to 2 months
  • 2 to 3 months
  • 4 to 6 monthsΔ

All infants at high risk of perinatal HIV transmission should have specimens obtained for HIV testing at birth before initiating an ARV drug regimen; however, presumptive HIV therapy should not be delayed.
Low-risk, formula-fed infants: Infants born to mothers who:
  • Had sustained viral suppression◊ (HIV RNA <50 copies/mL) after 20 weeks of gestation through delivery
 Perform virologic testing with NAT at the following ages:
  • Birth (suggested but not required)§
  • 14 to 21 days
  • 1 to 2 months¥
  • 4 to 6 months
Breastfed infants: Infants who are breastfed by a mother with HIV Perform virologic testing with NAT at the following ages:‡
  • Birth
  • 14 to 21 days
  • 1 to 2 months
  • 2 to 4 months†
  • 4 to 6 months
  • Then every 3 months throughout breastfeeding
  • 4 to 6 weeks after cessation of breastfeeding
  • 3 months after cessation of breastfeeding
  • 6 months after cessation of breastfeeding

All breastfed infants should have specimens obtained for HIV testing at birth before initiating an ARV drug regimen; however, ARV prophylaxis should not be delayed.
This table summarizes the recommended schedule for virologic testing in infants born to mothers with HIV according to the risk of perinatal transmission. To identify HIV infection in infants, HIV virologic testing must be performed using assays that detect HIV DNA or RNA, collectively referred to as "nucleic acid tests" (NATs). A positive result at any point should be confirmed as soon as possible with a repeat NAT. For additional information, refer to UpToDate topic on diagnostic testing for HIV in infants.

ART: antiretroviral therapy; ARV: antiretroviral; DNA: deoxyribonucleic acid; HIV: human immunodeficiency virus; NAT: nucleic acid test (DNA or RNA); RNA: ribonucleic acid.

* Viremia can be documented by a laboratory test or presumed from other clinical factors (eg, new diagnosis, ART adherence challenges, interruption in ART prior to delivery).

¶ For high-risk infants, virologic diagnostic testing is recommended at birth. For infants treated with multiple ARVs in the first 2 to 4 weeks of life, additional virologic testing is recommended 2 to 6 weeks after ARV drugs are discontinued (ie, at 8 to 12 weeks after birth).

Δ If a high-risk infant is breastfed, HIV testing should continue past 4 to 6 months based on the schedule outlined for low-risk breastfed infants.

◊ Sustained viral suppression is defined as HIV RNA <50 copies/mL on at least 2 consecutive tests obtained at least 4 weeks apart. However, when laboratory testing results are not available, it can be based on the clinical judgment of clinicians.

§ Testing at birth is not necessary for infants at low risk that are not being breastfed but may be done if there are concerns that the newborn could be lost to follow-up and not receive further testing.

¥ For low-risk infants, testing may be timed to occur at least 2 weeks after cessation of ARV prophylaxis.

‡ If the mother has a detectable viral load and continues breastfeeding, we prefer monthly virologic testing of the infant while the mother remains viremic.

† An additional virologic test should be performed at age 2 to 4 months if the gap between the tests at ages 1 to 2 months and 4 to 6 months is greater than 3 months.

Adapted from: Guidelines for the use of antiretroviral agents in pediatric HIV infection: Diagnosis of HIV infection in infants and children. National Institutes of Health. https://clinicalinfo.hiv.gov/en/guidelines/pediatric-arv/diagnosis-hiv-infection-infants-and-children?view=full (Accessed on January 3, 2025).
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