Early Infant Diagnosis of HIV

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Last updated June 10, 2014
Case Authors: 
Christian B. Ramers, MD, MPH
Assistant Professor of Medicine
Division of Infectious Diseases
Departments of Global Health and Medicine
University of Washington School of Medicine
Christopher Behrens, MD
Clinical Assistant Professor
Department of Global Health, Family Medicine, and Medicine
University of Washington School of Medicine 
Learning Objectives: 
  1. Describe appropriate methods for HIV testing in infants born to HIV-infected mothers.
  2. Describe the optimal timing of antiretroviral therapy initiation for infants diagnosed with HIV infection.

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References
  1. 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.
  2. Mphatswe W, Blanckenberg N, Tudor-Williams G, et al. High frequency of rapid immunological progression in African infants infected in the era of perinatal HIV prophylaxis. AIDS. 2007;21:1253-61.
  3. Prendergast A, Mphatswe W, Tudor-Williams G, et al. Early virological suppression with three-class antiretroviral therapy in HIV-infected African infants. AIDS. 2008;22:1333-43.
  4. WHO. Antiretroviral therapy of HIV infection in infants and children: towards universal access. Recommendations for a public health approach – 2010 revision. World Health Organization. Geneva, Switzerland.
  5. Lambert JS, Harris DR, Stiehm ER, et al. Performance characteristics of HIV-1 culture and HIV-1 DNA and RNA amplification assays for early diagnosis of perinatal HIV-1 infection. J Acquir Immune Defic Syndr. 2003;34:512-9.
  6. Nesheim S, Palumbo P, Sullivan K, et al. Quantitative RNA testing for diagnosis of HIV-infected infants. J Acquir Immune Defic Syndr. 2003;32:192-5.
  7. WHO. Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: recommendations for a public health approach – 2010 version. World Health Organization. Geneva, Switzerland.  
  8. WHO. Guidelines on HIV and infant feeding. 2010. Principles and recommendations for infant feeding in the context of HIV and a summary of evidence. WHO, Geneva, 2010.
  9. Brahmbhatt H, Kigozi G, Wabwire-Mangen F, et al. Mortality in HIV-infected and uninfected children of HIV-infected and uninfected mothers in rural Uganda. J Acquir Immune Defic Syndr. 2006;41:504-8.
  10. Newell ML, Coovadia H, Cortina-Borja M, Rollins N, Gaillard P, Dabis F. Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis. Lancet. 2004;364:1236-43.