A term infant is born to a known HIV- positive mother. She has been taking antiretroviral medications for the weeks prior to the delivery of her infant. Routine management of the healthy infant should include
The transmission of HIV from mother to infant has decreased in recent years, due in large pa to perinatal administration of antiretroviral medications to the mother and a course of zidovudine to the exposed infant. Studies suggest that a better than 50% decrease in transmission can be seen with appropriate medications as outlined. An ELISA is an antibody test and will be positive in the infant born to an HIV-infected mother due to maternal antibodies that are passed through the placenta; it is not a useful test in the newborn infant to determine neonatal infection. IVIG has not been shown to have a role in decreasing perinatal transmission. Healthy asymptomatic term infants born to HIV-infected mothers do not need special monitoring nor do they need routine radiographs.
Admission to the neonatal intensive care unit for close cardiovascular monitoring
HIV ELISA on the infant to determine if congenital infection has occurred
A course of zidovudine for the infant
Chest radiographs to evaluate for congenital Pneumocystis carinii