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Diagnosis of HIV in Infants less than 18 Months Old

Maternal HIV-specific antibodies may be detectable in the infant up to the age of 18 months. For this reason, the diagnosis of HIV infection in infants depends on detection of the virus. HIV-1 DNA PCR is the test of choice.

Testing at 6 weeks of age will detect ante- and intra-partum infection in ± 98% of infants. If the 6 week test is negative, repeat testing is recommended at 3 months. If the baby is breastfed and tests negative, testing should be repeated 2 - 6 weeks after breastfeeding is stopped.

If the baby is exposed to antiretrovirals as part of prevention of mother-to-child transmission (PMTCT), the HIV-1 DNA PCR should be done >2 weeks after discontinuing the antiretrovirals.

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Note: the HIV-1 DNA PCR only detects HIV-1. If infection with HIV-2 is suspected, an HIV-2 PCR can be done.

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