Care and Management of a Neonate Born to an HIV Positive Mother

Prevention of mother to child transmission (PMTCT) of Human Immunodeficiency virus (HIV) during pregnancy is one of the great successes over the last two decades. Various regimens have been tried, eventually leading to the achievement of very low rates of PMTCT of HIV. The ultimate aim is to eliminate the mother to child transmission (EMTCT) of HIV. EMTCT includes the period from preconception to 18 months of age or 6 weeks post-cessation of breastfeeding if continued beyond18 months. The number of HIV exposed uninfected (HEU) infants exposed to HIV and antiretrovirals is utero and during breastfeeding is increasing. The care of the newborn of an HIV positive mother should not end at birth. A continuum of care extending postpartum and postnatally is required to identify and prevent infections. Neonates born to HIV positive mothers are exposed in-utero to antiretroviral drugs, antibiotics, anti-tuberculous therapy etc. which may lead to altered fetal programming. Antiretroviral drugs have the potential of causing adverse effects in the newborn. One needs to have a high index of suspicion when examining an HIV exposed neonate. Investigations must be done timeously to prevent further complications and long-term follow up is required for some of the neonates.