HIV and Babies

Although the majority of cases of HIV in the US occur in adults, it’s also possible for babies to have this virus. Babies can be born with HIV, or they can acquire the virus shortly after birth.

Why are some babies born with HIV? Is there any way to prevent this? Will babies born with HIV be able to live normal lives?

Can a baby be born with AIDS or HIV?

If a mother is HIV-positive, then the virus can cross from her blood into the baby’s body through the placenta. The virus can also be transmitted during vaginal delivery, as mixing of the mother’s and baby’s blood during the process of birth is not uncommon. In addition, a baby can also acquire the virus through drinking the mother’s breastmilk.

An HIV-positive mother can take steps to reduce the chances that her baby will be born with HIV. The best way is for her to take antiretroviral therapy (ART) in order to keep her levels of the virus as low as possible. If the mother is diligent about taking her meds and maintains an undetectable viral load throughout the pregnancy, the risk of transmitting HIV to her baby is greatly reduced. She will also be able to safely give birth vaginally.

If the mother doesn’t have an undetectable viral load, then delivery by C-section is often recommended in order to decrease the chances of HIV transmission. Additionally, experts generally recommend that mothers with HIV don’t breastfeed their babies, since HIV can be transmitted through breastmilk.

A baby with HIV will generally not be born with full-blown AIDS, because the virus doesn’t have enough time to progress this far while the baby is in the womb. However, if the baby doesn’t get treatment for HIV, then it’s very likely to eventually lead to AIDS.

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Is AIDS a genetic disease?

Although babies can be born with HIV, this doesn’t make it a genetic disease. An HIV positive baby has generally acquired the virus from its mother through her bloodstream, or has acquired it shortly after birth through breastmilk. HIV/AIDS is not a genetic disease, but rather an infectious one.

Babies HIV symptoms

For a baby born with AIDS/HIV, the symptoms may include:

• Failure to thrive (not gaining weight and growing as expected, despite having enough food)
• Excessively frequent childhood illnesses (such as ear infections, diarrhea, and colds)
• Developmental delay (not gaining skills as expected)
• Seizures
• Trouble walking

These signs of HIV in babies can also indicate a variety of other diseases. Testing is important in order to determine the cause of a child’s symptoms. Just as in adults, a blood test is used to check for HIV in a baby. 

In some cases, the virus may not be detected until the child is older. A child born with AIDS/HIV may have frequent infections, including skin rashes, oral thrush (a yeast infection of the mouth), lung infections, and others. These symptoms of HIV in children may suggest that the child has the virus, but a blood test is needed in order to be sure.

For a baby born with HIV, life expectancy may be impacted. In the absence of treatment, about half of babies infected with HIV will die before their second birthday. However, the use of antiretroviral therapy (ART) has made a huge difference. For HIV positive children, the rate of death has declined by over 90% in the years since widespread use of ART for HIV-positive babies and children began. 

The current recommendation is to begin treatment as soon as possible after birth. This reduces the risk of severe illness or infant death, and decreases the chances that HIV will progress to AIDS in these children.

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Sources

AIDS/HIV and Children. Stanford Children’s Health. https://www.stanfordchildrens.org/en/topic/default?id=aidshiv-in-children-90-P02509. Accessed 18 April 2022.

Davies MA, Gibb D, et al. Survival of HIV-1 vertically infected children. Curr Opin HIV AIDS 2016 Sep;11(5):455–464. doi: 10.1097/COH.0000000000000303.

HIV and Pregnant Women, Infants, and Children. Centers for Disease Control and Prevention (2022). https://www.cdc.gov/hiv/group/gender/pregnantwomen/index.html. Accessed 18 April 2022. 

Using antiretroviral drugs to treat children under 3 years old who have HIV infection. Cochrane. https://www.cochrane.org/CD004772/HIV_using-antiretroviral-drugs-to-treat-children-under-3-years-old-who-have-hiv-infection. Accessed 18 April 2022.

U.S. Statistics on HIV. US Department of Health and Human Services (2021). https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics. Accessed 18 April 2022.