Congenital HIV-1 infection

Dana Vanino MD (Dr. Vanino of Geisinger Medical Center has no relevant financial relationships to disclose.)
Lucie Henry MS (Ms. Henry of Geisinger Medical Center has no relevant financial relationships to disclose.)
Kelly J Baldwin MD (Dr. Baldwin of Geisinger Medical Center has no relevant financial relationships to disclose.)
Karen L Roos MD FAAN, editor. (Dr. Roos of Indiana University School of Medicine has no relevant financial relationships to disclose.)
Originally released September 24, 1994; last updated January 22, 2017; expires January 22, 2020

This article includes discussion of congenital HIV-1 infection, human immunodeficiency virus-1 infection, pediatric acquired immunodeficiency syndrome, pediatric AIDS, and vertically acquired HIV-1 infection. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Congenital HIV infection is the transmission of HIV-1 from mother to child, which occurs during or soon after birth. Current prevalence ranges from 1% to 2% in the United States with successful implementation of antiretroviral treatment of mothers during pregnancy. This article includes an overview of congenital HIV-1 infection with updated criteria on reducing transmission through pregnancy and the delivery process, newborn testing for diagnosis, and treatment, including the use of zidovudine prophylaxis.

Key points

 

• Congenital HIV infection is maternal-to-child transmission of HIV-1.

 

• Prevalence is 1% to 2% in the United States with initiation of antiretroviral treatment of mothers during pregnancy.

 

• The disease can be mild to severe, including recurrent infections and neurologic abnormalities.

 

• All infants with HIV exposure should receive zidovudine prophylaxis within 6 to 12 hours after delivery.

 

• Newborn testing guidelines have been updated and are included for review.

Historical note and terminology

In 1982, soon after the initial descriptions of AIDS in homosexual men, Haitians, hemophiliacs, and intravenous drug users, 4 children with unexplained immunodeficiency and opportunistic infections were reported by the CDC (Centers for Disease Control 1982). It was not until the following year, however, that the clinical and immunologic features of pediatric AIDS were described in the literature (Oleske et al 1983; Rubinstein 1983).

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