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)

Supporting Assets

Table 1 | Table 2 | Table 3

Table 1. Coordinating Timing of HIV Testing With Well Child Care Visits in Infants With Known HIV Exposure

Age

HIV Testing

Well Child Care

Birth

Virologic
(Optional)

First hepatitis B immunization

14-21 days

Virologic*

Weight-adjust ART as needed

≥ 1 mos

Virologic*

Weight-adjust ART as needed; second hepatitis B immunization

≥ 2 mos

--

2-mo immunizations
(DTaP, IPV, PCV13, Hib, rotavirus)

≥ 4 mos

Virologic*

4-mo immunizations
(DTaP, IPV, PCV13, Hib, rotavirus)

≥ 6 mos

HIV antibody§

6-mo immunizations
(DTaP, PCV13, Hib, rotavirus)

15-18 mos

HIV antibody§

15- to 18-mo immunizations
(DTaP, IPV, PCV13, Hib)

DTaP, diphtheria, tetanus, and pertussis vaccines; Hib, Haemophilus influenzae type b; IPV, inactivated poliovaccine; PCV13, child Pneumococcal conjugate vaccine.
*A positive HIV virologic test should be repeated as soon as possible; 2 positive results from separate samples on different days confirm HIV infection regardless of age.
HIV infection can be presumptively excluded if both virologic tests at 14-21 days and 1-2 months are negative; therefore, there is no need to initiate Pneumocystis pneumonia prophylaxis in these children assuming there is a lack of laboratory or clinical evidence of HIV.
Completion of schedule (2 or 3 doses) will depend on which currently licensed vaccine is used.
§HIV antibody testing is optional if HIV infection has been presumptively excluded with virologic tests and should ideally be performed beyond 18 months of age to avoid maternal antibody detection.

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