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Human Immunodeficiency Virus (HIV)

Diagnosis: 

Testing protocols and forms for follow-up through the Wadsworth Center can be found at the Center's Pediatric HIV Testing Service page.

Prognosis: 

With treatment, the chance for mother to child transmission is less than 5%.

Treatment: 

The mother will be treated with antiretroviral medication during pregnancy and the baby will be treated shortly after birth until several weeks of age.  The baby may be delivered via C-section to reduce the risk of transmission and the mother may be instructed not to breastfeed.

Definition: 

Human immunodeficiency virus (HIV) can be transmitted from mother to baby during pregnancy, during delivery or through breast milk. Without treatment, infants born to mothers with HIV have up to a 35% chance of contracting the virus. Pregnant women are offered testing for HIV and newborns are tested at the hospital at birth if the mother’s status is unknown. HIV testing as part of newborn screening is another way to confirm that every infant exposed to HIV is identified and can receive monitoring and treatment.

How it is inherited: 

Not applicable.

Symptoms in carriers: 

Not applicable.

Newborn screening: 
  • New York State Method of Screening (First Tier): Screening for HIV exposure is accomplished by enzyme-linked immunosorbent assay (ELISA) which detects antibodies to HIV-1, the most common form of HIV.
  • Second Tier Screening: Western blot, which detects specific HIV proteins.
  • Interpretation/reporting of data: Results are reported as:
    • ELISA reactive, Western blot non-reactive
    • ELISA reactive, Western blot indeterminate
    • ELISA reactive, Western blot reactive
    • Screen negative
  • Testing can be affected by: ELISA will not detect acute or very early infections because the antibody response has not yet reached detectable levels. Western blot is used as a confirmatory test, but has lower sensitivity than ELISA. Therefore, newborns with a positive ELISA test and negative or indeterminate Western blot should be evaluated for exposure to HIV-1.
  • Newborn screening for exposure to HIV-1 will not identify HIV-2.
  • Referral to Specialty Care Center: There are no Specialty Care Centers for exposure to HIV-1. Abnormal newborn screens for exposure to HIV-1 are reported to the HIV designee at each hospital of birth for coordination of follow-up confirmatory testing with the primary care provider. A pediatric infectious disease specialist should manage follow-up care.