ARV Prophylaxis: Nevirapine (NVP) and Zidovudine (AZT) (Birth up to 2 months)
IMCI - Young Infant (Birth up to 2 months)
Give ARV Prophylaxis
| Risk Category | Scenario | Infant ART prophylaxis |
| LOW RISK (at birth) | Newborn infant of mother on ART with a VL result of <1000 copies/ ml at delivery | Nevirapine (NVP) for 6 weeks |
| HIGH RISK (at birth) |
At birth: • Mother on ART with a VL of >1000 copies/ ml at delivery or no HIV VL available at birth/ within the last 12 weeks before birth • Mother not on ART at delivery |
Nevirapine (NVP) for at least 12 weeks, until mother’s VL is <1000 copies/ ml or until 1 week after cessation of all breastfeeding AND Zidovudine (AZT) for 6 weeks |
| HIGH RISK (during breastfeeding) |
During breastfeeding: • Mother on ART with latest VL of >1000 copies/ ml • Mother not on ART |
Nevirapine (NVP) for at least 12 weeks, until mother’s VL is <1000 copies/ ml or until 1 week after cessation of all breastfeeding AND Zidovudine (AZT) for 6 weeks |
| HIGH RISK (exclusive formula feeding) |
Exclusively formula fed infant of: • Mother not on ART at delivery • Mother on ART with VL >1000 copies/ ml at delivery or no HIV VL at birth/ with the last 12 weeks before birth |
Nevirapine (NVP) for 6 weeks AND Zidovudine (AZT) for 6 weeks |
If at any stage the infant’s PCR test is positive, stop prophylaxis and initiate ART according to the six steps
Obtain expert advice on dosing of NVP and AZT for:
- Premature infants <35 weeks gestation and <2.0 kg
- Infants underweight for age (with WFA z-score < -3)
Nevirapine (NVP)
| Age | NEVIRAPINE (NVP) SOLUTION (10mg/ml) Once daily |
| Birth to 6 weeks |
Weight 2.0 - < 2.5 kg: 1 ml (10mg) daily Weight 2.5 kg or more: 1.5 ml (15mg) daily |
| 6 weeks up to 6 months | 2 ml (20mg) daily |
| 6 months up to 9 months | 3 ml (30mg) daily |
| 9 months until 1 week after breastfeeding stops | 4 ml (40mg) daily |
Zidovudine (AZT)
| Age | ZIDOVUDINE (AZT) SOLUTION (10mg/ml) Twice daily |
| Birth to 6 weeks |
Weight 2.0 - < 2.5kg kg: 1 ml (10 mg) twice daily Weight 2.5 kg: 1.5 ml (15 mg) twice daily |
| > 6 weeks |
Weight 3.0 - < 6 kg: 6 ml (60 mg) twice daily Weight 6 - 8 kg: 9 ml (90 mg) twice daily |
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Integrated Management of Childhood Illness 2022; Young Infant (Birth up to 2 months); Treat the Young Infant: Give ARV Prophylaxis: Nevirapine (NVP), Zidovudine (AZT).
Last checked for updates: June 2023