Not applicable.
Not applicable.
Not applicable.
- New York State Method of Screening (First Tier): Screening for HIV exposure is accomplished by microsphere immunoassay (MIA) which detects antibodies to HIV-1 and HIV-2.
- Second Tier Screening: HIV-1/HIV-2 supplemental immunoassay (SIA), which detects specific HIV proteins.
- Interpretation/reporting of data: Results are reported as:
- Reactive for HIV-1 antibodies (MIA reactive, SIA HIV-1 antibody reactive)
- Reactive for HIV-2 antibodies (MIA reactive, SIA HIV-2 antibody reactive)
- Reactive for HIV antibodies (MIA reactive, SIA HIV antibody reactive)
- Indeterminate for HIV antibodies (MIA reactive, SIA indeterminate or non-reactive). Although expected to be infrequent, an indeterminate result will be reported if the first-tier and second-tier immunoassay results do not match. For these cases, the report will indicate that the mother's HIV status must be verified to determine the infant's HIV exposure.
- Non-reactive for HIV antibodies (MIA non-reactive or MIA indeterminate, SIA non-reactive)
- Testing can be affected by: the timing of a mother's infection. If a woman becomes infected with HIV shortly before delivery, there may not be enough time for antibodies to reach sufficient levels in the mother to be detected in the infant. In this situation, HIV antibodies may not be detected by the newborn screening test, but the infant has been exposed and is at risk for HIV infection.
- Referral to Specialty Care Center: There are no Specialty Care Centers for HIV exposure. Abnormal newborn screens for HIV exposure are reported to the HIV designee at each hospital of birth for coordination of follow-up confirmatory testing with the primary care provider. A pediatric infectious disease specialist should manage follow-up care.
HIV screening of newborns detects HIV antibodies transferred to infants from their HIV-positive mothers. Detection of HIV antibodies in infants indicates exposure to HIV, not HIV infection. To determine if an HIV-exposed infant is infected or not, additional testing of the infant is required. Blood samples from exposed infants should be sent to the Pediatric HIV testing service for diagnostic HIV testing. Testing protocols and forms for follow-up through the Wadsworth Center can be found at the Center's Pediatric HIV Testing Service page.
The mother will be treated with antiretroviral medication during pregnancy and the baby will receive antiretroviral medications as prophylaxis shortly after birth until several weeks of age. The baby may be delivered via C-section to reduce the risk of transmission and the current recommendation is that women living with HIV not breastfeed.
Prevention of mother to child transmission is dependent on many factors including HIV treatment during pregnancy, the mother's viral load during pregnancy and at delivery, and medicines given to the infant after birth to aid in preventing HIV infection.
Human immunodeficiency virus (HIV) can be transmitted from mother to baby during pregnancy, during delivery or through breast milk. Infants born to women living with HIV who have not received antiretroviral treatment have up to a 25% chance of contracting the virus. Pregnant women are offered testing for HIV at the initial prenatal visit with a recommendation for repeat testing in the third trimester. Newborns are tested at the hospital at birth if the mother’s status is unknown. HIV testing as part of newborn screening is another way to confirm that every infant exposed to HIV is identified and can receive monitoring and treatment.