Management of Indeterminate PCR Results in Infants.
Click on the image to enlarge. # Final HIV status cannot be determined until the infant has stopped all antiretroviral prophylaxis and is at least 6 weeks post-cessation of breastfeeding. In cases where clients have been initiated on ART and diagnosis remains uncertain, clients should be referred for further management by a specialist clinical and laboratory team. ART should never be stopped with
Click on the image to enlarge.
# Final HIV status cannot be determined until the infant has stopped all antiretroviral prophylaxis and is at least 6 weeks post-cessation of breastfeeding. In cases where clients have been initiated on ART and diagnosis remains uncertain, clients should be referred for further management by a specialist clinical and laboratory team. ART should never be stopped without specialist supervision.
PCR, polymerase chain reaction; VL, viral load; ART, antiretroviral therapy
If in doubt, discuss with a virologist, or contact the NICD at HIV@nicd.ac.za Document all test barcodes in the RTHB and referral letters
$ A positive HIV rapid test will confirm HIV exposure and assist clinical management. However, a negative HIV rapid test may be falsely negative. Due to the unavailability of the mother, the HIV-exposure status of an infant with a negative rapid test can therefore not be definitively established. For this reason, all abandoned infants should have an HIV-PCR test performed and be managed as a higher-risk HIV-exposed infant. An HIV rapid test therefore adds value if it is positive but does not change the management of the infant if it should be negative.
Care of the HIVexposed but Uninfected Infant
South African National Department of Health, Guideline for Vertical Transmission Prevention of Communicable Infections, Version 2_August 2023