A neonate born to an HIV-positive mother with a viral load of 50 copies/mL at delivery receives zidovudine prophylaxis. At what age should the first HIV DNA PCR be performed to reliably detect in utero infection?

• A At birth (within 48 hours)
• B At 3 months of life
• C At 4-6 weeks of life
• D At 14-21 days of life ✓

Explanation

The first HIV DNA PCR should be performed at 14-21 days of life. A PCR done at birth may miss infections acquired late in labor or during delivery. Two negative PCRs (one at ≥14 days and one at ≥4 weeks) with a negative result at 4 months reliably excludes HIV in non-breastfed infants. Testing at birth is used to detect in utero infection but a negative result does not rule out infection.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.