The Bloodborne Viruses Laboratory provides pediatric HIV testing to definitively diagnose HIV infection in infants who are born to HIV-infected mothers. To diagnose HIV infection in this age group, HIV DNA or RNA must be detected using a nucleic acid test (NAT). Antibody based tests cannot be used because maternal HIV antibodies are transferred to the infant and can persist for up to 18 months.
HIV infection can be excluded in HIV-exposed infants after they have two negative NAT results, one when they are at least one month old and another when they are at least four months old. HIV infection is confirmed when there are two positive NAT results performed on separate specimens collected at any age. Tests Include:
APTIMA HIV-1 RNA qualitative assay (Hologic): The APTIMA HIV-1 RNA Qualitative Assay is an in vitro nucleic acid test (NAT) for the detection of HIV-1 in human plasma and serum. It is intended for use as an aid in the diagnosis of HIV-1 infection, including acute or primary infection. During the APTIMA assay, viral RNA is released and captured by HIV-1 specific oligonucleotides. The HIV-1 RNA is amplified by transcription-mediated amplification and detected by complementary chemiluminescent nucleic acid probes. The APTIMA assay produces a qualitative result and is reported as detected or not detected.
HIV-2 Nucleic Acid Testing: The BVL uses a lab-developed, real-time PCR assay to detect and quantify HIV-2 RNA.
Recommendations on Timing of Testing
Two to four specimens per infant may be necessary to determine the infant's HIV infection status. Any infant, regardless of age, with a positive NAT result should have another blood specimen collected for testing as soon as possible to confirm the positive result. No further testing is needed for diagnosis after the second positive result. Recommendations for specimen collection for pediatric HIV testing are as follows:
- within 48 hours after birth
- two weeks of age
- four to six weeks of age
- four to six months of age
Note: Negative NAT results in an infant younger than 28 days do not exclude HIV infection, particularly if the infant has been exposed to antiviral medication in utero or after birth.
How to Submit Specimens for Pediatric HIV Testing
- Obtain a Pediatric HIV test kit from the Order Desk (518) 474-4175
- Follow collection guidelines for pediatric HIV testing
- Complete the DOH-3917 test requisition form
- Ship specimens using UPS shipping label enclosed in Pediatric HIV test kit
- For full details please see Collection, Shipping and Reporting