Will my baby need HIV drugs after they are born?

Yes. All babies need to take a short course of HIV drugs for the first four weeks of life, if their mother is living with HIV.

This post exposure prophylaxis (PEP) should be started as soon as possible after birth and at least within four hours.

If the mother has been on ART for longer than 10 weeks and has had two undetectable viral load results during pregnancy and at 36 weeks, the baby will be given two weeks of AZT.

Four weeks of AZT is recommended if the mother’s viral load is undetectable at 36 weeks but has not been throughout pregnancy or the baby is premature.

And combination PEP is recommended if the mother’s viral load is more than 50 on day of birth, if there is concern about her adherence or if her viral load is not known.

Swiss guidelines – an exception

In 2019, Swiss guidelines included some situations where a baby does not need to be given HIV meds.

So far, guidelines in all other countries, including the UK, are more cautious and still recommend a short course of treatment 

Ref: Swiss Federal Office of Public Health. Recommendations of the Swiss Federal Commission for Sexual Health (FCHS) for medical care of HIV-infected women and their offspring.
https://www.bag.admin.ch/dam/bag/en/dokumente/mt/p-und-p/richtlinien-empfehlungen/fcsh-mtct-hiv.pdf.download.pdf/fcsh-mtct-hiv.pdf

Last updated: 1 November 2023.