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Guidelines Issued on Managing Infants Exposed to HIV

TUESDAY, Oct. 20, 2020 -- In a clinical report from the American Academy of Pediatrics, published online Oct. 19 in Pediatrics, guidelines are presented for the evaluation and management of infants exposed to HIV.

Ellen Gould Chadwick, M.D., from the Feinberg School of Medicine at Northwestern University in Chicago, and colleagues recommend maternal HIV infection be identified before or during pregnancy whenever possible. Routine HIV testing is recommended for all pregnant women, unless the patient declines testing. Expedited HIV antibody testing on the mother or newborn should be performed if the mother's HIV serostatus is unknown at the time of birth. For women living with HIV, avoidance of breastfeeding continues to be a strong recommendation.

The researchers also recommend pediatricians provide counseling about HIV infection to parents and caregivers of infants exposed to HIV, including counseling on routine care, diagnostic tests, and potential drug toxicities. Infants exposed to HIV should undergo virological testing at 14 to 21 days of age. If negative, these tests should be repeated at 1 to 2 and 4 to 6 months of age. Infants exposed to antiretroviral agents in utero should be monitored for drug toxicity. For infants exposed to HIV, immunizations and tuberculosis screening should be provided in accordance with published guidelines. Immediate family members of infants exposed to HIV should be offered HIV testing.

"We have come a long way in helping mothers manage perinatal HIV exposures to prevent transmission," Chadwick said in a statement. "We encourage open communication between doctors, patients and their families so that all appropriate therapies can be provided."

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Posted: October 2020

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