The Bloodborne Viruses Laboratory provides pediatric HIV testing to definitively diagnose HIV infection in infants who are born to people living with HIV.  To diagnose HIV infection in this age group, HIV DNA or RNA must be detected using a nucleic acid test (NAT).  Antibody-based tests cannot be used because maternal HIV antibodies are transferred to the infant and can persist for up to 18 months. 

HIV infection can be excluded in HIV-exposed infants after they have two negative NAT results, one when they are at least one month old and another when they are at least four months old.  HIV infection is confirmed when there are two positive NAT results performed on separate specimens collected at any age. Tests Include:

HIV-1 RNA Testing: The BVL conducts HIV-1 RNA testing by real-time transcription-mediated amplification (TMA) using the FDA-approved qualitative method on serum and plasma specimens.  In addition, the BVL has conducted validation studies and has received NYSDOH CLEP approval for 

  • qualitative detection of HIV-1 RNA on dried blood spots (DBS); BVL has determined the limit of detection in DBS to be 2500 copies/ml
  • the use of smaller volumes of pediatric serum and plasma specimens; BVL has determined the limit of detection for 100ul of serum and plasma to be 84 copies/ml
  • extended temperature stability in whole blood, serum, plasma and DBS specimens for qualitative detection of HIV-1 RNA

HIV-2 Nucleic Acid Testing: The BVL uses a NYSDOH CLEP-approved real-time PCR assay to detect HIV-2 RNA in serum and plasma (qualitative) and quantify HIV-2 RNA in plasma (viral load).


Recommendations on Timing of Testing

Two to five specimens per infant may be necessary to determine the infant's HIV infection status.  Any infant, regardless of age, with a positive NAT result should have another blood specimen collected for testing as soon as possible to confirm the positive result.  No further testing is needed for diagnosis after the second positive result. In accordance with NYS clinical guidelines, our laboratory requests specimens to be collected at the following times from HIV exposed infants:

  • within 48 hours after birth
  • 2 weeks of age
  • 4 to 6 weeks of age
  • 8 to 12 weeks of age (for infants at greatest risk for perinatal HIV infection)
  • 4 to 6 months of age

Note:  Negative NAT results in an infant younger than 28 days do not exclude HIV infection, particularly if the infant has been exposed to antiviral medication in utero or after birth. 

How to Submit Specimens for Pediatric HIV Testing

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