General Condition Information
- Congenital HIV
- Congenital human immunodeficiency virus
- Neonatal HIV
- Neonatal human immunodeficiency virus
It is estimated that fewer than 100 babies are born with this condition each year in the United States.
What is Human immunodeficiency virus
Human immunodeficiency virus (HIV) is a virus that attacks the body’s immune system. If untreated, HIV can lead to the acquired immunodeficiency syndrome (AIDS). HIV spreads through contact with certain body fluids or blood from an HIV-infected person.
When a pregnant mother has an HIV infection or AIDS, the virus can infect the baby during pregnancy, delivery, or while breastfeeding. HIV is passed on from mother to infant most often during delivery (perinatal transmission). Treatment of a mother with HIV infection during pregnancy with antiviral medications can reduce a baby’s chance of getting the infection.
The best way to prevent babies from HIV infection is to screen all pregnant women for HIV infection. Pregnant women who are infected with HIV then receive antiviral medications to reduce the amount of virus. While around 5,000 babies are born each year in the United States to HIV-infected mothers, less than 100 babies are born with an HIV infection each year due to the use of screening and antiviral therapy.
Babies infected with HIV before birth will not have any health problems right away, but often develop signs and symptoms a little later in life.
Newborn Screening and Follow-Up
The Centers for Disease Control and Prevention (CDC) recommends that all pregnant women receive screening for HIV infection. HIV-infected women can receive antiviral therapy to prevent them from passing HIV to the baby. A state may offer an additional test for HIV exposure through newborn screening. Newborn screening for HIV requires collecting a small amount of blood from your baby’s heel. To learn more about this process, visit the Blood Spot Screening page.
Screening measures whether your baby’s blood contains HIV antibodies. Antibodies are special proteins the body’s immune system makes in response to an infection. Pregnant women pass antibodies on to their babies.
If your baby’s HIV antibody screen is positive, your baby’s health care provider will contact you. Together, you will discuss next steps and follow-up plans.
A positive HIV screening result indicates that your baby was possibly exposed to HIV during your pregnancy or delivery. It does not mean that your baby is infected or will have or develop health problems. It does mean that your baby needs more follow-up testing.
Your baby may need the following tests after a positive HIV screening result:
- Blood tests (usually repeated every couple of months for the first year of life)
You should complete any recommended follow-up testing as soon as possible. Babies with this condition may develop health problems if they are not diagnosed and treated.
False-positive screening results for HIV can and do happen.
Newborn screening helps babies lead healthier lives. If your baby has a positive HIV result, follow up with your health care provider quickly. It is important to follow their instructions. Your baby may need to get treatment, even if they are not showing signs or symptoms. In some cases, your baby’s health care provider may decide it is best to watch (monitor) your baby to decide next steps. Careful monitoring and early treatment will help your baby stay as healthy as possible.
Babies with HIV will have no health problems at birth but will develop signs and symptoms, usually within 4 to 18 months, occasionally a few years later.
Signs of the condition include the following:
- Poor growth and weight gain
- Creamy white dots in the mouth or throat that do not get better (thrush)
- High number of infections or infections caused by germs that do not affect healthy babies
- Large lymph nodes
- Multiple ear infections
- Large liver or spleen (hepatomegaly or splenomegaly)
- Developmental delay
Pregnant women can pass HIV to their unborn or recently born baby. A mother with HIV or AIDS can pass on HIV to her baby during pregnancy, childbirth, or while breastfeeding.
The risk of transmission from mother to baby is highest during labor and delivery, followed by breastfeeding, and lowest during pregnancy itself.
HIV is not inherited through a person’s genes. The risk for HIV infection in siblings will depend on how well the mother’s HIV infection is controlled during those pregnancies.
There are a number of ways you can reduce your risk of your baby being infected with HIV:
- Take antiretroviral therapy (ART) during and after pregnancy to prevent the virus from making copies of itself
- Talk to your health care provider about whether a cesarean delivery (C-section) would be safer
- Feed your baby with formula or donor breastmilk instead of breastfeeding
- Do not pre-chew your baby’s food
Treatment and Management
Babies born to HIV-infected mothers will receive a short course of antiviral medicine to help prevent infection (prophylaxis). Babies with a HIV infection will get treatment right away with additional antiviral medicines. It is important to talk to your health care provider about which treatment(s) are best for your baby. The goal of treatment is to try to prevent some of the health problems this condition causes.
Treatment options can include the following:
- HIV medicines (zidovudine and others)
- Antibiotics to help prevent infections
- Modification of routine vaccinations if infant is severely immunocompromised