Infant of HIV Positive Mother

Infant of HIV Positive Mother


Breastfeeding/expressed breast milk (EBM) is not recommended if mother is known HIV positive, regardless of maternal antiretroviral therapy and/or viral load due to the risk of transmission to the infant

Universal precautions for blood and body fluid: wash injection site prior to IM injection or blood sampling

Initial Management/Medications

Mother must meet ALL criteria:

  • On combination antenatal antiretroviral therapy with optimal adherence
  • HIV viral load <40 copies/mL within 4 weeks of delivery
  • Consistent prenatal/HIV care

Moderate risk: Mother received antenatal antiretroviral drug therapy but HIV viral load >40 copies/mL near delivery (known or projected)

High risk: Mother did not receive antenatal antiretroviral therapy in pregnancy

Additional Information

  • Infant Diagnostic HIV PCR - Send 2mL in one EDTA tube (lavender top), PHSA Lab Serology Screening Requisition #00073506 Request Infant Diagnostic HIV PCR under Other Tests

    • For low risk: send within 48h after birth
    • For moderate or high risk: send within 90 minutes after birth
  • Complete blood count (CBC) with differential

  • Aspartate aminotransferase (AST)

  • Alanine aminotransferase (ALT)

  • Bilirubin, total unconjugated and conjugated

  • Urea

  • Creatinine (Cr), serum

  • Saliva Swab CMV

  • Oak Tree Clinic staff (604-875-2250) are available to provide telephone advice Monday-Friday 8:30-16:30 (leave message if after hours)
  • After 16:30 and on weekends, contact BC Children's Hospital (604-875-2161) and ask for the Pediatric Infectious Disease specialist on call

Algorithm Overview

INFANT born to HIV-positive mother: Initial management