Skip to main content
SpringerLink
Log in
Book cover

Neonatal Infections pp 127–134Cite as

Management of HIV-Exposed Infants

  • Chapter
  • First Online:

  • 1356 Accesses

Abstract

The majority of new human immunodeficiency virus (HIV) infections in children are acquired perinatally, thus emphasizing the importance of effective management of this vulnerable group of infants born to mothers with HIV. Dramatic declines in new childhood HIV infections since 1995 are largely attributable to global efforts to prevent mother-to-child transmission. These efforts include HIV testing, providing antiretroviral treatment (ART) to pregnant and breastfeeding women living with HIV, antiretroviral (ARV) prophylaxis to infants born to mothers with HIV, intrapartum zidovudine when maternal viral load is not suppressed, and cesarean delivery. The recommendations for diagnosis, treatment, and prevention of HIV infection among pregnant women and their infants are constantly evolving, and the most current recommendations can always be found at https://aidsinfo.nih.gov.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. World Health Organization. Global health observatory data. Available at http://www.who.int/gho/hiv/en/. Accessed 13 Feb 2018.

  2. Connor EM, Sperling RS, Gelber R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med. 1994;331:1173–80.

    Article  PubMed  CAS  Google Scholar 

  3. Centers for Disease Control and Prevention. Enhanced perinatal surveillance—15 areas, 2005–2008. HIV Surveillance Supplemental Report.

    Google Scholar 

  4. Townsend CL, Byrne L, Cortina-Borja M, et al. Earlier initiation of ART and further decline in mother-to-child HIV transmission rates, 2000-2011. AIDS. 2014;28:1049–57.

    Article  PubMed  Google Scholar 

  5. Humphrey JH, Marinda E, Mutasa K, et al. Mother to child transmission of HIV among Zimbabwean women who seroconverted postnatally: prospective cohort study. BMJ. 2010;341:c6580.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bunders MJ, van der Loos CM, Klarenbeek PL, et al. Memory CD4(+)CCR5(+) T cells are abundantly present in the gut of newborn infants to facilitate mother-to-child transmission of HIV-1. Blood. 2012;120:4383–90.

    Article  PubMed  CAS  Google Scholar 

  7. Rouzioux C, Costagliola D, Burgard M, et al. Estimated timing of mother-to-child human immunodeficiency virus type 1 (HIV-1) transmission by use of a Markov model. Am J Epidemiol. 1995;142:1330–7.

    Article  PubMed  CAS  Google Scholar 

  8. Lewis SH, Reynolds-Kohler C, Fox HE, et al. HIV-1 in trophoblastic and villous Hofbauer cells, and haematological precursors in eight-week fetuses. Lancet. 1990;335:565–8.

    Article  PubMed  CAS  Google Scholar 

  9. Nielsen K, Bryson YJ. Diagnosis of HIV infection in children. Pediatr Clin N Am. 2000;47:39–63.

    Article  CAS  Google Scholar 

  10. International Perinatal HIVG, Andiman W, Bryson Y, de Martino M, et al. The mode of delivery and the risk of vertical transmission of human immunodeficiency virus type 1—a meta-analysis of 15 prospective cohort studies. N Engl J Med. 1999;340:977–87.

    Article  Google Scholar 

  11. Mofenson LM, Lambert JS, Stiehm ER, et al. Risk factors for perinatal transmission of human immunodeficiency virus type 1 in women treated with zidovudine. Pediatric AIDS Clinical Trials Group Study 185 Team. N Engl J Med. 1999;341:385–93.

    Article  PubMed  CAS  Google Scholar 

  12. Marinda ET, Moulton LH, Humphrey JH, et al. In utero and intra-partum HIV-1 transmission and acute HIV-1 infection during pregnancy: using the BED capture enzyme-immunoassay as a surrogate marker for acute infection. Int J Epidemiol. 2011;40:945–54.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Nielsen-Saines K, Watts DH, Veloso VG, et al. Three postpartum antiretroviral regimens to prevent intrapartum HIV infection. N Engl J Med. 2012;366:2368–79.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  14. Welles SL, Pitt J, Colgrove R, et al. HIV-1 genotypic zidovudine drug resistance and the risk of maternal—infant transmission in the women and infants transmission study. The Women and Infants Transmission Study Group. AIDS. 2000;14:263–71.

    Article  CAS  PubMed  Google Scholar 

  15. Bollen LJ, Whitehead SJ, Mock PA, et al. Maternal herpes simplex virus type 2 coinfection increases the risk of perinatal HIV transmission: possibility to further decrease transmission? AIDS. 2008;22:1169–76.

    Article  PubMed  Google Scholar 

  16. Garcia-Tejedor A, Perales A, Maiques V. Duration of ruptured membranes and extended labor are risk factors for HIV transmission. Int J Gynaecol Obstet. 2003;82:17–23.

    Article  PubMed  CAS  Google Scholar 

  17. U.S. Department of Health and Human Services. AIDSinfo—Recommendations for the use of antiretroviral drugs in pregnant women with HIV infection and interventions to reduce perinatal HIV transmission in the United States. https://aidsinfo.nih.gov/guidelines/html/3/perinatal-guidelines/0. Accessed 13 Feb 2018.

  18. Lepage P, Hitimana DG. Natural history and clinical presentation of HIV-1 infection in children. AIDS. 1991;5:S117–25.

    Article  PubMed  Google Scholar 

  19. Caldwell MB, Oxtoby MJ, Simonds RJ, Rogers MF. Revised classification system for human immunodeficiency virus infection in children less than 13 years of age. MMWR Reccomm Rep. 1994;43:1–10.

    Google Scholar 

  20. Dunn DT, Brandt CD, Krivine A, et al. The sensitivity of HIV-1 DNA polymerase chain reaction in the neonatal period and the relative contributions of intra-uterine and intra-partum transmission. AIDS. 1995;9:F7–11.

    Article  PubMed  CAS  Google Scholar 

  21. Read JS, Committee on Pediatric AIDS. Diagnosis of HIV-1 infection in children younger than 18 months in the United States. Pediatrics. 2007;120:e1547–62.

    Article  PubMed  Google Scholar 

  22. Violari A, Cotton MF, Gibb DM, et al. Early antiretroviral therapy and mortality among HIV-infected infants. N Engl J Med. 2008;359:2233–44.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. U.S. Department of Health and Human Services. AIDSinfo—Guidelines for the use of antiretroviral agents in pediatric HIV infection. https://aidsinfo.nih.gov/guidelines/html/2/pediatric-treatment-guidelines/0. Accessed 14 Feb 2018.

  24. Donnelly M, Davies JK. Contemporary management of human immunodeficiency virus in pregnancy. Obstet Gynecol Clin N Am. 2014;41:547–71.

    Article  Google Scholar 

  25. Cu-Uvin S, Caliendo AM, Reinert S, et al. Effect of highly active antiretroviral therapy on cervicovaginal HIV-1 RNA. AIDS. 2000;14:415–21.

    Article  PubMed  CAS  Google Scholar 

  26. Kennedy CE, Yeh PT, Pandey S, Betran AP, Narasimhan M. Elective cesarean section for women living with HIV: a systematic review of risks and benefits. AIDS. 2017;31:1579–91.

    Article  PubMed  Google Scholar 

  27. Rowland BL, Vermillion ST, Soper DE. Scheduled cesarean delivery and the prevention of human immunodeficiency virus transmission: a survey of practicing obstetricians. Am J Obstet Gynecol. 2001;185:327–31.

    Article  PubMed  CAS  Google Scholar 

  28. Persaud D, Gay H, Ziemniak C, et al. Absence of detectable HIV-1 viremia after treatment cessation in an infant. N Engl J Med. 2013;369:1828–35.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  29. Rainwater-Lovett K, Luzuriaga K, Persaud D. Very early combination antiretroviral therapy in infants: prospects for cure. Curr Opin HIV AIDS. 2015;10:4–11.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. U.S. Department of Health and Human Services. AIDSinfo—Guidelines for the prevention and treatment of opportunistic infections in hIV-exposed and HIV-infected children. https://aidsinfo.nih.gov/guidelines/html/5/pediatric-oi-prevention-and-treatment-guidelines/0. Accessed 14 Feb 2018.

  31. Gaur AH, Dominguez KL, Kalish ML, Rivera-Hernandez D, Donohoe M, Brooks JT, et al. Practice of feeding premasticated food to infants: a potential risk factor for HIV transmission. Pediatrics. 2009;124(2):658–66.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA

    Wei Li A. Koay MD & Allison L. Agwu MD

Authors
  1. Wei Li A. Koay MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Allison L. Agwu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Allison L. Agwu MD .

Editor information

Editors and Affiliations

  1. University of Texas Health Science Center San Antonio, San Antonio, Texas, USA

    Joseph B. Cantey

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Koay, W.L.A., Agwu, A.L. (2018). Management of HIV-Exposed Infants. In: Cantey, J. (eds) Neonatal Infections. Springer, Cham. https://doi.org/10.1007/978-3-319-90038-4_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-90038-4_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90037-7

  • Online ISBN: 978-3-319-90038-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation