Pediatrics Group Updates Guidelines on Managing HIV-Exposed Infants

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

The American Academy of Pediatrics has updated its guidelines on caring for infants born to women with HIV infection.

Among the changes:

• While 6 weeks of zidovudine has traditionally been the standard chemoprophylaxis regimen for HIV-exposed infants, 4 weeks may be sufficient for term infants whose mothers received antiretroviral therapy during pregnancy and had documented viral suppression. Treatment should begin as early as possible — and "certainly within 6 to 12 hours after delivery."

• Infants at highest risk for HIV infection should have an HIV nucleic acid amplification test (NAAT) at birth or in the first few days after delivery. (Previously, such testing "might be considered.") High-risk infants include those whose mothers did not receive antiretroviral therapy during pregnancy and those whose mothers acquired HIV during pregnancy. For exposed infants at average HIV risk, an NAAT should be performed at 14–21 days of age.

The full guidelines are available for free in Pediatrics. Follow the link below.