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July 2016 NEWSLETTER

HIV IN CHILDREN
July 2016 Newsletter
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A 3 kg male child was born to an HIV-1 infected mother. Mother was detected to be HIV infected in 7th month of gestation and was on tenofovir, lamivudine and efavirenz for the past 2 months. Baby was born at term by emergency caesarean section due to meconium stained amniotic fluid. Parents had opted not to breast feed the child and the baby was started on formula feeds. Due to unavailability of syrup formulation of anti-retrovirals, the parents were advised to pulverise the adult 200mg tablet of nevirapine (NVP) into 6 mg sachet at a local pharmacy and give the child 6mg daily. However, the child was given 200mg NVP twice a day on second day of life (recommended dose is 2 mg/kg/day). Attendant doctor noticed this error on rounds and stopped NVP. NVP drug levels in the blood could not be done due to non-availability. The child was monitored and did not have any rash, liver dysfunction or neutropenia.

Why did the infant not get toxicity and when should the child be restarted on prophylaxis?

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