Baby with HIV

Whether or not you have taken any antiretroviral treatments during pregnancy, your baby will be treated with HIV antiretroviral treatments for a period of 4 to 6 weeks to improve his or her chance of being HIV negative. This treatment is called post-exposure prophylaxis (commonly known as PEP). PEP can prevent HIV infection by ‘mopping up’ infectious HIV particles to which your baby may have been exposed. It is not fail-safe but it increases the likelihood of avoiding infection. Your baby may experience side-effects but many babies do not.

Your baby will be given a simple blood test after birth (a PCR test) to look for the presence of HIV in their blood. Your baby will then be tested regularly for the virus over the next six months. Babies are generally considered HIV negative at three months of age if all of the tests have been negative and the baby has not been breastfed. Testing continues until your baby is about 18 months old to be sure the baby is not infected.

It can be very difficult to learn that your child has HIV. You (and your partner if you have one) will probably need a lot of support and may benefit from referral to professional services such as a counsellor or other support groups to help you cope.

Although it can be distressing, early diagnosis means you can begin to provide your child treatment and care to help them live a long healthy life. HIV antiretroviral treatment is very effective in children, making HIV a long-term manageable condition.

Medical care for children with HIV is very specialised. You will be referred to a clinic that specialises in paediatric HIV care. You can expect staff to be friendly, welcoming and non-judgemental. They will make sure you have a team of people to support you and your child as they grow, including doctors, nurses, pharmacists and also psychologists and social workers if that is useful. If you do not live near a specialist clinic, they will arrange to ‘share care’ with a doctor who lives closer to home.

You will need to make decisions about your child’s treatment after discussions with your paediatrician. There is some debate about the best time to begin antiretroviral treatment for babies – whether to start straight away or to wait until your baby shows immune decline or symptoms or markers that suggest he or she is at risk of HIV progression. Children under one are at risk of progression to AIDS without treatment. Your paediatrician and your HIV doctor should talk with you about all available evidence and how this applies to your baby. If your baby doesn’t commence HIV treatment immediately, they will need to take drugs to prevent common infections.