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Are babies tested for HIV at birth? The Body: Rick Sowadsky M.S.P.H., C.D.S, Answers to Safe Sex Questions
Jan 28, 1997

Are babies tested for HIV at birth, if the mother wasn't tested during pregnancy? If so, are the parents notified if the results are positve?I

Response from Mr. Sowadsky

Hi. Thank you for your question.

This is actually a very controversial subject. At the present time, I know of no place that requires babies to be tested for HIV at birth. If such a policy were in place, it would be more like testing the mother rather than the child. This is because, whether the baby is infected or not, the newborn baby will test positive on an HIV antibody test if the mother is infected. This is due to the fact that the mothers antibodies against HIV will go into the babies blood during pregnancy. So when the baby would be tested, we are actually testing the mothers antibodies, not the childs. The mothers antibodies will remain in the baby until the baby is approximately 18 months of age. At that point in time, antibody tests in babies will be accurate in determining if the baby is infected. Because testing newborns is more like testing the mother, there have been issues raised about whether testing the mother (through testing her newborn baby) is ethical or not. This is why newb orn testing is so controversial.

If we want to test the baby directly, and the baby is less than 18 months of age, we cannot do a standard antibody test, again, because we would be detecting the mothers antibodies, not the babies. To test the baby at this age, we have to use specialized tests that look for the virus itself. This would usually be a diagnostic Qualitative PCR test. Because these tests are very expensive, and difficult for labs to perform, they are not designed for routine testing situations. However, if the mother is already known to be positive, physicians would use this test to check to see if the baby is infected (if its less than 18 months of age).

Since testing every newborn baby with PCR tests is not feasible, we therefore recommend (but do not require) that the mother gets tested for HIV as part of her routine prenatal care. This is because, if we know the mother is positive, we can reduce the chance that the baby will become infected. To do this, we treat the mother with AZT and other drugs during pregnancy, and then treat the newborn baby with AZT and other drugs immediately after birth. Doing so will reduce the chances that the baby will become infected. Without any type of medical intervention, there is a 25% chance that the baby will become infected. With medical intervention (including the use of AZT), we can reduce the chance that the baby will become infected to about 8%.

In summary, testing newborn babies is much more like testing the mother, rather than the baby itself. A much more successful screening program would involve testing the mother during her prenatal care. This would be much more beneficial since we can then reduce the chance that the baby would become infected. However, presently, I know of no place that requires testing of the mother or the newborn child for HIV. However, things may be changing in the near future, regarding requirements for testing of mothers or newborn babies.

If you have any further questions, please feel free to contact the Centers for Disease Control at 1.800.232.4636 (Nationwide).



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