An 8-week-old boy diagnosed with HIV is seen in clinic for follow-up evaluation after a diagnosis of HIV was confirmed 2 days prior. The child was born to a mother who was diagnosed with HIV at the time of delivery, and the mother’s initial HIV RNA level was 71,357 copies/mL. The infant was prescribed a 6-week course of three-drug antiretroviral prophylaxis after birth, but there were concerns about the number of actual doses the infant received. Four days ago the infant had HIV RNA testing and the result was positive. Repeat HIV RNA testing of the infant 2 days ago is now also positive. Initial Laboratory studies for the infant show a CD4 count of 1,238 cells/mm3, CD4 percentage of 31%, and an HIV RNA level of 237,200 copies/mL. An HIV genotypic drug resistance test is ordered.
Which one of the following is the most appropriate management for the infant?
Figure 1. Death and Disease Progression in Infants Receiving Early or Deferred Antiretroviral Therapy
Source: Violari A, Cotton MF, Gibb DM, et al. Early antiretroviral therapy and mortality among HIV-infected infants. N Engl J Med. 2008;359:2233-44.
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Question Last Updated
September 26th, 2023
September 26th, 2023
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