Antiretroviral prophylaxis regimens for neonates at low risk of perinatal transmission of HIV
Australasian Society for Infections Diseases (ASID), 2022
For neonates at low risk of perinatal transmission of HIV, 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 at low risk of perinatal transmission, use:
zidovudine orally zidovudine
neonate born at 34 weeks gestation or more: 4 mg/kg 12-hourly for 4 weeks
neonate born at 30 to less than 34 weeks gestation: 2 mg/kg 12-hourly for 2 weeks, then 2 mg/kg, 8-hourly for an additional 2 weeks
neonate born at less than 30 weeks gestation: 2 mg/kg, 12-hourly for 4 weeks.
For neonates at low risk of perinatal transmission who do not tolerate oral medication, zidovudine can be given intravenously, use:
zidovudine 1.5 mg/kg, intravenously; switch to oral therapy once oral intake is toleratedzidovudine
neonate born at 34 weeks gestation or more: 6-hourly
neonate born at less than 34 weeks gestation: 12-hourly.