A newborn has been exposed in utero to HIV. Management involves:

A newborn has been exposed in utero to HIV. Management involves:

• A. Consult with a pediatric HIV specialist.
• B. Discontinue cART after 4 weeks of age.
• C. Obtain a CD4+ cell count and HIV RNA levels.
• D. Reinforce the need to give cART for life.

Answer: (A)

Coordinated, specialist-led care for HIV-exposed newborns is essential. A pediatric HIV specialist can tailor antiretroviral prophylaxis for the infant based on maternal treatment and viral status, decide on the appropriate testing plan, and arrange timely follow-up to determine whether transmission occurred. The goal is to prevent infection if possible and to identify infection early with virologic testing (such as HIV DNA or RNA PCR) rather than relying on infant CD4 counts, which are not reliable for diagnosing HIV in newborns. Lifelong antiretroviral therapy is reserved for infants who are confirmed to be infected, not for all exposed newborns.

Coordinated, specialist-led care for HIV-exposed newborns is essential. A pediatric HIV specialist can tailor antiretroviral prophylaxis for the infant based on maternal treatment and viral status, decide on the appropriate testing plan, and arrange timely follow-up to determine whether transmission occurred. The goal is to prevent infection if possible and to identify infection early with virologic testing (such as HIV DNA or RNA PCR) rather than relying on infant CD4 counts, which are not reliable for diagnosing HIV in newborns. Lifelong antiretroviral therapy is reserved for infants who are confirmed to be infected, not for all exposed newborns.