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adoption - birth mother may be HIV positive
Aug 25, 2001

We are currently in the process of accepting a referral for an infant who's mother had 2 positive HIV tests and 4 negative HIV tests during pregnancy.

In reviewing all of the various information on HIV testing that we have received from numerous sources, we are trying to piece it all together and form the best plan going forward for HIV testing to ensure the infant if HIV negative.

Known: 1. The birth mother, while pregnant, had 2 HIV tests with positive results. We believe they were both standard HIV antibody tests. 2. The birth mother, while pregnant, had 4 HIV tests with negative results. We believe they were all standard HIV antibody tests. 3. The infant was born via C-section. 4. The infant was born 7/14/01 and has been healthy since birth. 5. Neither the infant nor the birth mother have been tested since birth.

Assumptions (valid?): 1. If the mother is HIV negative, the baby will be HIV negative. 2. Testing the mother during pregnancy can lead to a false positive HIV test, especially if the mother has previously given birth.

Recommended next steps:

1. Re-test the infant's mother, now that she is no longer pregnant.

Which test should be used -- antibody or PCR test or both?

If the infant's mother tests negative, is there any need to test the infant?

If the PCR test is administered, how many tests are needed?

2. If the mother tests positive, then the infant should be tested.

Which test should be used -- antibody or PCR test or both?

If the PCR test is administered, how many tests are needed? Can a PCR test be administered on an infant less than 2 months old?

Response from Dr. Jackson

The mother should be retested with a licensed HIV antibody test. If the test is negative, she is almost certainly negative for HIV as is the baby. If the mother is HIV antibody positive with the screening test and confirmed positive by Western blot, then the baby should be tested both for HIV antibody and by HIV PCR (either DNA PCR or RNA PCR)if the baby is less than 18 months of age.

BJ


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