Neonatal Antiretroviral Management According to Risk of HIV Infection

Low

Mother received ART during pregnancy.

Mother did not have acute or early HIV infection diagnosed during pregnancy.

Mother had sustained virologic suppression (as shown by HIV plasma viral load < 50 copies/mL from 20 weeks gestation through delivery).

There were no concerns about mother's adherence to ART.

Antiretroviral prophylaxis: ZDV for 2 weeks

High

Mother did not receive ART during pregnancy.

Mother did not receive antepartum or intrapartum ART.

Mother received only intrapartum ART.

Mother received antepartum and intrapartum ART but had an unknown or a detectable (≥ 50 copies/mL) HIV plasma viral load in the 4 weeks before delivery.

Mother had early or acute HIV infection during pregnancy or breastfeeding (chestfeeding) (in which case breastfeeding should be stopped immediately).

Mother had unconfirmed HIV status with ≥ 1 positive HIV test at delivery or postpartum.

Three-drug presumptive HIV therapy: ZDV, lamivudine, and either nevirapine ZDV, lamivudine, and either nevirapineor raltegravir (combination given from birth for 2 to 6 weeks)raltegravir (combination given from birth for 2 to 6 weeks)