Q and A

The baby’s meds when the mother is living with HIV?

The information on this page is based on guidelines that were correct at the time of posting. Please always talk to your doctor or health team about medication and dosing for a baby. Guidelines also can change.

All babies are given HIV meds (PEP) if their mother is living with HIV.

  • This should be started within 4 hours.
  • These are given as liquids (syrups) so it is easy for the baby to take.

This gives extra protection from HIV even if the baby’s risk is already very low.

The meds for the baby include one or more of these three syrups:

  • nevirapine (NVP).
  • zidovudine (AZT).
  • lamivudine (3TC).

Which meds are used, and for how long, depends on which country you live in.

Please talk to your nurse or doctor about which of these are recommended for your baby.

Tables 1 and 2 below show the differences in UK and WHO guidelines.

Table 1: British HIV Association (BHIVA) guidelines (2000)

Also most high-income countries in Europe and the US etc.

Babies start meds (syrup) within four hours of birth.

Risk Details Daily ARV syrups Duration
Lowest risk Mother on ART for more than 10 weeks and two VL <50 at birth. AZT only 2 weeks
Low risk Baby born before 34 weeks and mother only one VL <50 at birth. AZT only 4 weeks
Higher risk Mother’s VL > 50 or unknown at birth. AZT + 3TC + NVP 4 weeks

*Adapted from BHIVA pregnancy guidelines (2020 update). Section 9.1, page 85.

Table 2: World Health Organisation (WHO) guidelines (2016)

Most lower-income countries including Africa, Asia and the rest of the world.

Risk Details Daily ARV syrup’s * Duration **
Lowest risk Mother’s VL <1000 at birth AND on ART for more than 4 weeks. NVP only 4 to 6 weeks

OR

12 weeks depending on country
Higher risk Mother not on ART for more than 4 weeks OR

VL >1000 in 4 weeks before birth.

 AZT + NVP 6 weeks (if only using formula milk).

12 weeks (if breastfeeding).

*   These countries use different meds:

  • Botswana
  • Tanzania
  • Zamibia

* These countries offer a MINIMUM of 12 weeks meds:

  • Eswatini
  • Kenya
  • Namibia
  • South Africa
  • Zambia

Ref:  WHO. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach, 2nd ed. (June 2016).

Co-trimoxazole

Co-trimoxazole is a different type of medicine for the baby. It is not used to protect against HIV. It is a combination of two antibiotics. This medication is used to stop other infections. It is given to baby when a screening test is positive for HIV.

Baby will continue with co-trimoxazole if baby then is diagnosed with HIV.

  • Co-trimoxazole is also known as Septrin, Ilvitrim or Bactrim.

Last updated: 15 August 2024.