Antiretroviral prophylaxis regimens for neonates at high risk of perinatal transmission of HIV

Australasian Society for Infections Diseases (ASID), 2022

In Australia, it is uncommon that a neonate is at high risk of perinatal transmission of HIV. To reduce transmission and ensure appropriate follow-up, if a neonate is assessed to be at high risk of perinatal transmission, urgent instituted multidisciplinary care is required for both the birthing parent (eg mother) and the neonate.

For neonates at high risk of perinatal transmission, a 3-drug regimen (lamivudine, nevirapine and zidovudine) is required. The 3-drug regimen varies depending on whether the birthing parent has taken nevirapine and the gestational age of the neonate at birth. Regimens are included in these guidelines for neonates with a birthing parent who has:

• never taken nevirapine or has been taking nevirapine for 3 days or less
• taken more than 3 days of antenatal nevirapine.

For more detailed information, see the Australasian Society for Infectious Diseases (ASID) guideline Management of Perinatal Infections.