A neonate born to an HIV-positive mother (viral load undetectable at delivery) is to be given ARV prophylaxis. Which prophylaxis regimen is recommended for a LOW-RISK HIV-exposed neonate in India per current NACO guidelines?
- A Zidovudine alone for 4 weeks ✓
- B Triple-drug therapy (AZT + 3TC + NVP) for 6 weeks
- C Nevirapine alone for 6 weeks
- D No ARV prophylaxis needed if maternal viral load is undetectable
Correct answer: A. Zidovudine alone for 4 weeks
Explanation
For low-risk HIV-exposed neonates (mother on ART with suppressed viral load, delivered vaginally or by elective CS, no breastfeeding or infant on exclusive replacement feeding), NACO/WHO guidelines recommend zidovudine alone for 4 weeks as prophylaxis. Triple-drug prophylaxis (option B) is reserved for high-risk infants (mother with high/unknown viral load, no ART, or late booking). Nevirapine alone (option C) is used in resource-limited settings for mothers who received intrapartum NVP only. Withholding prophylaxis entirely is not recommended even with undetectable VL.
Reference: Ghai Essential Pediatrics, 10th ed.
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