How is HIV testing performed in newborns?

Updated: Sep 19, 2018
  • Author: David J Cennimo, MD, FAAP, FACP, AAHIVS; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The diagnosis of human immunodeficiency virus (HIV) infection in the newborn is complicated by the fact that antibodies from the HIV-infected mother can be passively transferred to the newborn and can be detectable for up to 18 months. [48] A positive serologic test result in the newborn is informative when the mother’s HIV status is unknown. In this case, the newborn should be started on antiretroviral therapy within the first 12 hours of life. A negative test result is informative, as it indicates the absence of HIV infection unless the mother is in the window period.

The criterion standard for the diagnosis of HIV-1 infection in infants and children younger than 18 months relies on detection of the viral nucleic acid. A diagnosis of HIV-1 infection can be established or excluded using this technique within the first several weeks of life in the nonbreastfed infant. Guidelines for the diagnostic evaluation of HIV-1 infection in the newborn can be found elsewhere. [48, 53]


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