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Information from Your Family Doctor
Preventing HIV Infection in Your Baby
Am Fam Physician. 2002 May 15;65(10):2061-2062.
What is HIV?
HIV means human immunodeficiency virus. HIV infection causes AIDS. AIDS means acquired immunodeficiency syndrome. AIDS is the illness caused by HIV infection. It is possible to have HIV infection for a long time before the illness (AIDS) shows up.
How can my baby get HIV?
Even if a mother has HIV infection but not AIDS, she can pass HIV to her baby during pregnancy, during labor, or after delivery. Most babies who get infected with HIV get the virus during labor.
If you have HIV infection, there is a 1 to 30 percent chance that you will pass HIV to your baby. The degree of risk depends on your own health and what you do to keep your baby from getting HIV.
What can I do to keep my baby from getting HIV?
If you have HIV infection or AIDS, there are some things you can do to cut the risk that your baby will get infected with the virus:
Start taking or keep taking antiviral medicines during your pregnancy. These medicines can lower the amount of HIV (the viral load) in your body.
Work closely with your doctor to keep your baby from being born early. Your doctor may also want you to have a cesarean delivery (also called a C-section).
Don't breastfeed your baby, because HIV can spread to your baby in your breast milk.
Be sure that your baby takes a medicine called zidovudine (also called AZT; brand name: Retrovir) four times a day from birth until 6 weeks of age. Babies who take this medicine are less likely to get HIV.
Talk to your doctor before you think about getting pregnant. Be sure to see your doctor regularly as soon as you think you are pregnant.
How is my baby tested for HIV?
Your baby will have a blood test for HIV within a few hours after birth. This test will be done again when your baby is 1 month old and again when your baby is about 4 to 6 months old.
If these three blood tests show no HIV in your baby's blood, it is almost certain that your baby is not infected. However, one last HIV test has to be done when your baby is 18 months old. Until then, your doctor will look at your baby often for signs of HIV infection. If one HIV blood test is positive, your doctor will do the test again. Your baby might get some other tests to look for HIV infection.
Is my baby also more likely to get other illnesses?
Babies who get HIV might also get other illnesses, like hepatitis B, hepatitis C, and tuberculosis. During your pregnancy, it is important for you to be tested for these diseases. If you have any of them, your baby will also be tested for them at birth, and treated if necessary.
Babies with HIV are more likely to get lung infections like Pneumocystis carinii pneumonia (also called PCP). Sometimes a baby gets PCP even before a blood test shows that the baby has HIV.
All babies of mothers with HIV infection or AIDS have to take an antibiotic all the time so that they will not get PCP. The antibiotic is usually trimethoprim-sulfamethoxazole (brand names: Bactrim and Septra). Your baby should start taking this medicine at 6 weeks of age. If the HIV test at 4 to 6 months of age is negative, your baby can stop taking this medicine. Babies with HIV infection have to keep taking the medicine until they are 1 year old.
What doctor appointments does my baby need?
Just like other children, babies of mothers with HIV infection need regular check-ups. Your doctor will measure your baby's growth and development, check for infections, and answer your questions.
Your baby will also get most of the same shots (vaccines) that other babies get. Check with your doctor about when your baby needs to get vaccines.
Also, talk with your doctor about what to do when your baby gets sick. In general, you should call your doctor if your baby:
Has a rectal temperature higher than 100.5°F
Gets a rash
Has trouble breathing
Has vomiting or diarrhea for more than 24 hours
Where can I get more information?
You can get more information about HIV and babies by calling these numbers:
AIDS Hotline: 1-800-342-2437
Centers for Disease Control and Prevention National Prevention Information Network: 1-800-458-5231
HIV/AIDS Treatment Information Service: 1-800-448-0440
The Body, an HIV and AIDS information service, at this Web address: www.thebody.com
Your state and local health departments (see Yellow Pages)
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 2002 by the American Academy of Family Physicians.
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