Antiretroviral prophylaxis regimens for neonates at very low risk of perinatal transmission of HIV

Australasian Society for Infections Diseases (ASID) 2022

For neonates at very low risk of perinatal transmission, antiretroviral prophylaxis with zidovudine monotherapy is recommended, even if the birthing parent (eg mother) has a history of zidovudine resistance. Prophylaxis should start as soon as possible after birth (within 4 hours). Neonatal antiretroviral prophylaxis is complex and requires consultation with an HIV specialist.

For antiretroviral prophylaxis in neonates born at 36 weeks gestation or more who are at very low risk of perinatal transmission, use:

zidovudine 4 mg/kg orally, 12-hourly for 2 weeks. zidovudine

For neonates born at 36 weeks gestation or more who do not tolerate oral medication, use:

zidovudine 1.5 mg/kg intravenously, 6-hourly. Switch to oral therapy once oral intake is tolerated.zidovudine