Management of Children With or Exposed to HIV

  • Authors: James A. McAuley, MD, MPH; Mariam Aziz, MD (More Info)
  • Editors in Chief: Joseph J. Eron, Jr., MD; Daniel R. Kuritzkes, MD
  • Last Reviewed: 2/17/20 (What's New)

Summary

Introduction

  • An estimated 1.7 million children are living with HIV infection worldwide[UNAIDS]
  • Mother-to-child HIV transmission is rare in well-resourced settings but more common in resource-limited countries
  • Pediatric HIV infection is characterized by:
    • Distinct clinical and virologic manifestations of perinatal HIV infection in growing, immunologically immature persons
    • In utero, intrapartum, and/or postpartum neonatal exposure to ART
    • The need for HIV virologic tests instead of antibody tests to diagnose perinatal HIV infection in infants younger than 18 months of age
    • Age-specific differences in CD4+ cell counts
    • Age-specific changes in drug metabolism and clearance
    • Issues associated with ART adherence in infants and young children

Management of the HIV-Exposed Newborn