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Case 4: Management and Monitoring of Neonates Born to HIV-Infected Mothers

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C The appropriate test was performed. Regardless of what the result shows, the infant does not need prophylaxis against Pneumocystis pneumonia since the mother’s CD4 count is greater than 200 cells/mm3.

This answer is incorrect.The appropriate test was ordered to diagnose HIV in this setting, but all HIV exposed neonates should receive prophylaxis against Pneumocystis pneumonia beginning at 6 weeks of age, regardless of what the mother’s immune status is at the time of the delivery.

A The test ordered was inappropriate and the results are meaningless. The infant should have been screened with an HIV antibody test instead of a HIV PCR test.
B The appropriate test was performed. Based on these results the infant is not infected with HIV and no additional testing is necessary. The infant requires no medication at this time.
D The appropriate test was sent, but additional HIV PCR testing will be necessary. In addition, the child should have an HIV antibody test performed at 18 months of age. The infant should receive 6 weeks of zidovudine, followed by prophylaxis against Pneumocystis pneumonia.

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