HIV NEONATES -IMCI

APPROACH

DR G SINGOGO-PRESENTER
 THINK OF HIV TESTS INTO TWO
GROUPS
These Tests Are Divided Into
1. 1-Children Under 18 Months,
2. 2-Children 18 Months Or
Older.
 WHAT TEST SHOULD BE USED IF THE
CHILD IS 18 MONTHS OR OLDER?
You Will Use A Serological Test To
Determine The HIV Status Of A
Child 18 Months Or Older.
If The Serological Test Is
POSITIVE It Confirms The Child’s
Status As HIV Infected.
 WHAT TEST SHOULD BE USED IF THE
CHILD IS UNDER 18 MONTHS OLD?
A Virological test (PCR) Is The Only Reliable
Method To Determine The Child’s HIV Status
Below 18 Months Of Age. It Detects The
Actual Virus In The Child’s Blood
More recently the NAT (Nucleic Acid Test) -
Test Can Be Done Just After Birth If
POSITIVE –It Is Very Reliable More Than
PCR In The Neonatal Period
1-Serological Tests/Rapid Test (THESE DETECT ANTIBODIES)

What Does How Can You Interpret Test

Serological/Rapid HIV Antibodies Pass From
Test Detect Mother To Child But
These Tests Detect Antibodies Do Not Completely
Antibodies Made Disappear Until The Child Is
By Immune Cells 18 Months Of Age. This Means
In Response To That A Positive Serological
HIV. They DO Test In Children Under The
NOT Detect The Age Of 18 Months Is Not A
HIV Virus Itself. Reliable Way To Check For
Infection Of The Child.
 2- VIROLOGICAL TESTS (e.g. PCR & NAT)

What Does Virological How Can You Interpret Test

Test Detect 1. Positive Virological Test Result At
Any Age Are Reliable, Even Before
The Child Is 18 Months Old.
These Tests 2. If The Tests Are Negative And The
Directly Detect Child Has Been Breastfeeding,
There Is Always RISK of Infection
The Presence With Breastfeeding
Of The HIV 3. The Baby May Have Just Become
Infected. Tests Should Be Done Six
Virus Or Weeks Or More After
Products Of Breastfeeding Has Completely
Stopped – Only Then Do The Tests
The Virus In Reliably Rule Out Infection.
The Blood.
 THERE ARE TWO SCENARIOS FOR
CHILDREN UNDER 18 MONTHS
1. FIRST -IF PCR or other Virological TEST IS
AVAILABLE, TEST FROM 4–6 WEEKS OF
AGE + A POSITIVE Result Means That The
Child Is Infected, As It Detects The Actual
Presence Of HIV In The Child –
2. A NEGATIVE Result Means That Child Is Not
Infected, But MAY Become Infected If They Are
Still Breastfeeding
 NAT Can Be Done From BIRTH And Is
Reliable -NEW
 SUMMARY SO FAR
1. HIV Testing Is Essential For Assessing And Classifying A
Child For HIV- Assess A Child Based On His HIV Tests And
Clinical Signs.
2. A Positive Serological HIV Test Cannot Confirm HIV
Infection For Children Below 18 Months. This Is Because The
Test Shows The Presence Of Maternal Antibodies – And
Children Under 18 Months Can Still Have Antibodies From
Their Mothers. However, A Negative Test Is Useful Because It
Usually Excludes HIV Infection From The Mother, So Long As
The Child Has Not Been Breastfed For More Than 6 Weeks.
3. Breastfeeding Matters -A Child Can Be Infected With HIV
Through Breast Milk. An HIV Test Can Only Be Confirmed
Once A Child Has Stopped Breastfeeding For At Least 6
Weeks.