Dosing Charts for Prophylaxis for the HIV-Exposed Infant
Summary of Infant Prophylaxis Regimens Dosing Charts for Infant HIV Prophylaxis in Infants > 2000 g Dosing Charts for Infant HIV Prophylaxis in Preterm Infants < 2000 g Dosing Chart for Intravenous (IV) AZT Prophylaxis Summary of Infant Prophylaxis Regimens Risk Profile NVP AZT At birth (following maternal delivery VL review) Low-risk, whether breastfed or formula-fed 6 weeks Stop AZ
Summary of Infant Prophylaxis Regimens
Dosing Charts for Infant HIV Prophylaxis in Infants > 2000 g
Dosing Charts for Infant HIV Prophylaxis in Preterm Infants < 2000 g
Dosing Chart for Intravenous (IV) AZT Prophylaxis
Summary of Infant Prophylaxis Regimens
| Risk Profile | NVP | AZT | |
| At birth (following maternal delivery VL review) | Low-risk, whether breastfed or formula-fed | 6 weeks | Stop AZT |
| Higher-risk and breastfed ** | minimum of 12 weeks | 6 weeks | |
| Higher-risk and exclusively formula fed | 6 weeks | 6 weeks | |
| During breastfeeding | Higher-risk during breastfeeding | minimum of 12 weeks | 6 weeks |
Dosing Charts for Infant HIV Prophylaxis in Infants > 2000 g
| NVP and AZT dosing table for prophylaxis at birth and during breastfeeding (see also “VL Non-Suppression Algorithm”) |
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| NVP (Daily) |
AZT (Twice daily) |
|
| Birth – 6 weeks (2.0 – 2.49 kg) | 1 mL (10 mg) daily | 1 mL (10 mg) twice daily |
| Birth – 6 weeks (≥ 2.5 kg) | 1.5 mL (15 mg) daily | 1.5 mL (15 mg) twice daily |
| 6 weeks – 6 months | 2 mL (20 mg) daily | 6 mL (60 mg) twice daily |
| 6 weeks – 6 months | 3 mL (30 mg) daily | Children > 6 months of age requiring AZT prophylaxis should use treatment doses. |
| 9 – 24 months | 4 mL (40 mg) daily | |
Dosing Charts for Infant HIV Prophylaxis in Preterm Infants < 2000 g
| Nevirapine, oral, once daily | ||
| Weight | First 2 weeks after birth (mg of NVP) | After first 2 weeks after birth (mg of NVP) |
| 500 to < 625 g | 0.1 mL (1 mg) | 0.2 mL (2 mg) |
| 625 to < 850 g | 0.15 mL (1.5 mg) | 0.3 mL (3 mg) |
| 850 to < 1200 g | 0.2 mL (2 mg) | 0.4 mL (4 mg) |
| 1.2 to < 1.5 kg | 0.3mL (3 mg) | 0.5 mL (5 mg) |
| 1.5 to < 2.0 kg | 0.35 mL (3.5 mg) | 0.6 mL (6 mg) |
| If the infant at the time of discharge is severely underweight-for-age (3 SD or 3 z-scores below the mean), give NVP according to weight (i.e. 4 mg/kg/dose daily) until in the normal weight-for-age range. |
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| Zidovudine (AZT), oral, twice daily | ||
| Gestational age at birth | 30–35 weeks | <30 weeks |
| First 2 weeks after birth | 0.2 mL/kg (2 mg/kg) | 0.2 mL/kg (2 mg/kg) |
| 2 – 4 weeks after birth | 0.3 mL/kg (3 mg/kg) | 0.2 mL/kg (2 mg/kg) |
| 4 – 6 weeks after birth | 0.4 mL/kg (4 mg/kg) | 0.3 mL/kg (3 mg/kg) |
| > 6 weeks after birth | 0.4 mL/kg (4 mg/kg) | 0.4 mL/kg (4 mg/kg) |
Dosing Chart for Intravenous (IV) AZT Prophylaxis
| Gestational Age | Approximate birth weight | AZT IV dosing for the first 14 days (If unable to tolerate oral agents) |
| ≥ 35 weeks | ≥ 2.5 kg | 3 mg/kg body weight IV every 12 hours |
| < 35 weeks | < 2.5 kg | 1.5 mg/kg body weight IV every12 hours |
South African National Department of Health, Guideline for Vertical Transmission Prevention of Communicable Infections, Version 2_August 2023